Impact of standard-pressure and low-pressure laparoscopic cholecystectomy on postoperative complications: a randomized controlled trial

Background: this study aimed to evaluate the effect of standard-pressure and low-pressure laparoscopic cholecystectomy on postoperative tip shoulder pain, nausea, and vomiting. Materials and Methods: This double-blind trial was conducted in the department of General Surgery in Imam Reza Hospital, affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran from January 2020 to June 2021. A total of 104 patients for laparoscopic cholecystectomy were recruited, 52 patients in each group randomly (low pressure received 7-9 mmHg vs. standard pressure received 14-15 mmHg). Postoperative tip shoulder pain, nausea, and vomiting were studied. Result: The mean intensity of nausea at 2 (5.7±0.91 vs. 5.3±0.80, p-value= 0.019) and 12 hours (1.9±0.79 vs. 1.3±0.76, p-value= 0.001) after surgery in standard pressure group was significantly higher than low pressure group. The mean intensity of vomiting at recovery (4.3±0.81 vs. 3.9±0.70, p-value= 0.008), 2 (3.5±0.68 vs. 3.2±0.71, p-value= 0.030), and 6 hours (2.7±1.3 vs. 2.2±0.96, p-value= 0.028) after surgery in standard pressure group was significantly higher than low pressure group. The mean intensity of shoulder tip pain at recovery (5.1±0.97 vs. 4.7±0.96, p-value= 0.037) and 4 hours (3.2±0.75 vs. 2.7±0.61, p-value= 0.001) after surgery in standard pressure group was significantly higher than low pressure group. Conclusion: Low pressure laparoscopic surgery is safe with least intensity of post-operative tip shoulder pain, nausea, and vomiting when performed by experienced surgeons.

Impact of standard-pressure and low-pressure laparoscopic cholecystectomy on postoperative complications: a randomized controlled trial Keywords:

Laparoscopic cholecystectomy , pneumoperitoneum , nausea , vomiting , shoulder tip pain.