HEMODYNAMIC, RESPIRATORY, AND METABOLIC EFFECTS OF LAPAROSCOPIC CHOLECYSTECTOMY

In 10 patients undergoing laparoscopic cholecystectomy, creation of pn eumoperitoneum caused immediate venous hypertension and stasis in the lower extremities as measured by percutaneous catheter and duplex scan ning. These changes disappeared after deflation. As measured by spirom etry, significant reductions in forced vital capacity of 23% and force d expiratory volume in 1 second of 22% were present 24 hours after sur gery, and plasma interleukin-6 levels rose to 18 pg/mL. The visual ana logue wale of resting pain increased to a median value of 2.5 postoper atively. When compared with other studies of open cholecystectomy, our results showed fewer restrictions of ventilation, lower cytokine leve ls, and lower pain scores. The minimal soft tissue trauma and early am bulation after laparoscopic cholecystectomy may decrease the risk of t hrombosis despite an acute episode of venom stasis.