PULMONARY-FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Background. The purpose of this study was to prospectively compare the effect of laparoscopic cholecystectomy (LC) versus open cholecystecto my (OC) on postoperative pulmonary function. Methods. Forty consecutiv e patients (20 in each group) who were evenly matched in terms of pulm onary risk factors were assigned to either elective LC or OC. Pulmonar y function studies, oxygen saturation, and chest radiography were perf ormed on both groups before and after the operation until baseline lev els were reached. Narcotic requirements and pulmonary complications we re compared. The t test, ANOVA, and chi-squared analysis were used. Re sults. Compared to the patients who underwent OC, patients who underwe nt LC had a significant reduction in postoperative pulmonary impairmen t (30% to 38%) in all areas studied including forced vital capacity; f orced expiratory volume in 1 second; forced expiratory flow, mid-expir atory phase; maximum forced expiratory flow; maximum voluntary ventila tion; total lung capacity; and oxygen saturation. Pulmonary function r eturned to baseline levels 4 to 10 days sooner after LC. Pulmonary com plications including atelectasis and hypoxia were less frequent after LC. An eight-fold decrease was noted in postoperative pain medication requirement in the LC group. Conclusions. Compared to OC, laparoscopic cholecystectomy results in a significantly reduced compromise in pulm onary function and narcotic requirement leading to fewer postoperative pulmonary complications. Laparoscopic cholecystectomy should be consi dered the procedure of choice for elective cholecystectomy.