POSTOPERATIVE PULMONARY CHANGES AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic cholecystectomy (LC) has been widely used in recent years because of short postoperative hospital stays and low morbidity. In t his study, 24 patients were prospectively evaluated with preoperative and postoperative spirometry, arterial blood gas determinations, and c hest radiographs to quantitate the magnitude of postoperative pulmonar y changes after LC. Statistically significant reductions were noted in forced vital capacity (FVC) (mean decrease, 810 mL) and forced expire d volume in 1 second (FEV(1)) (mean decrease, 420 mL). Clinically impo rtant changes in arterial blood gas values did not occur. Of 20 postop erative chest films, 7 showed the development of atelectasis or effusi on and 9 showed persistence of subdiaphragmatic free air 24 hours afte r LC. In summary, LC caused mean decreases of 23% in FVC and 16% in FE V(1) 24 hours after surgery. The physiologic derangements that follow LC are sufficiently small that all but the most severely impaired pati ents with pulmonary disease should be able to tolerate this operation.