HEMODYNAMIC AND PULMONARY CHANGES DURING AND AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A COMPARISON WITH TRADITIONAL SURGERY

Background: The cardiopulmonary changes experienced by patients who un dergo laparoscopic cholecystectomy (LC) and the prognostic value of pa tient characteristics are not well understood. Methods: Cardiorespirat ory changes were investigated in 120 patients undergoing LC or open ch olecystectomy (OC), The results and their relation to patient variable s were statistically evaluated. Results: The most significant cardiore spiratory changes were (A-a)PO2 increase during OC; decrease of pH and compliance and increase of peak airway pressure during LC; impairment of arterial blood gas mean values and respiratory muscle strength; at electasis and pneumonia (five cases) after OC; and lamellar atelectasi s (two cases) after LC. Significant adverse prognostic factors related to intra- and postoperative LC cardiorespiratory changes were ASA cla ss greater than I, FEF75-85% < 900 ml, and PaO2 < 10.4 kPa (PPV, 71.4% and 46.6%, respectively). Conclusions: LC carries no significant card iorespiratory changes provided that intraoperative monitoring of hemod ynamics and respiratory parameters is done for the study of blood gas values in all patients at risk.