Effect of Low Pressure Versus High Pressure Pneumoperitoneum on Liver Functions in Laparoscopic Cholecystectomy

Abstract

Introduction: Intra-operative and post-operative outcomes are largely affected by the pneumoperitoneum used in laparoscopic cholecystectomy. Aim: To assess the impact of high pressure and low pressure pneumoperitoneum in selected group of patients undergoing laparoscopic cholecystectomy. Materials and Methods: Sixty patients with confirmed diagnosis of chronic cholecystitis with cholelithiasis undergoing laparoscopic cholecystectomy were randomised into two groups. Group I- in which low pressure pneumoperitoneum (14 mm of Hg) was used intra-operatively. The two groups were compared using unpaired t-test. Results: There was no significant difference in bilirubin and ALP in both the groups but serum Aspartate Aminotransferase (AST) and Alkaline phosphatase (ALP) were raised significantly postoperatively in group II patients. Operative time, hospital stay and time to return to normal routine was less in group I postoperatively but this was statistically non-significant. Conclusion: As post-operative liver function tests were deranged more in patients who underwent laparoscopic cholecystectomy using high pressure pneumoperitoneum, low pressure pneumoperitoneum may be recommended in laparoscopic cholecystectomy when performed by experienced surgeons.

Keywords

• intra-operative and post-operative outcomes
• liver function
• surgery