PNEUMOPERITONEUM AFTER LAPAROSCOPIC CHOLECYSTECTOMY - FREQUENCY AND DURATION AS SEEN ON UPRIGHT CHEST RADIOGRAPHS

OBJECTIVE. This study aimed to determine the frequency and duration of pneumoperitoneum after laparoscopic cholecystectomy, as detected on u pright chest radiographs. MATERIALS AND METHODS. Fifty-five patients w ho underwent laparoscopic cholecystectomy were studied prospectively. Upright posteroanterior chest radiographs were obtained 6 hr after sur gery (day 1); additional radiographs were obtained on days 2, 4, 7, an d 14, if required, until the pneumoperitoneum resolved. A perpendicula r measurement of any pneumoperitoneum detected between the diaphragm a nd the liver was obtained. The pneumoperitoneum was graded as absent, trace (1-5 mm), mild (6-10 mm), or moderate (10-15 mm). RESULTS. No ev idence of pneumoperitoneum was seen on chest radiographs taken 6 hr af ter surgery (day 1) in 27 (54%) of the 50 patients who completed the s tudy. Of the remaining 23 patients (46%), all but one showed resolutio n of the pneumoperitoneum in the first week. Of these 23 patients, 17 showed trace pneumoperitoneum and six showed mild pneumoperitoneum on chest radiographs. CONCLUSION. Despite the use of carbon dioxide gas d uring laparoscopic cholecystectomy, a significant number of patients h ave postsurgery pneumoperitoneum that is visible on upright chest radi ographs. The pneumoperitoneum resolves in most patients within the fir st week after surgery.