Abstract

SHORT TERM OUTCOMES IN PATIENTS UNDERGOING NORMAL PRESSURE PNEUMOPERITONEUM IN PATIENTS OF LAPROSCOPIC CHOLECYSTECTOMY VERSUS CHOLELITHIASIS USING LOW PRESSURE PNEUMOPERITONEUM: A COMPARISON STUDY

Dr. Shah Wali*, Dr. Syed Dawood Shah, Dr. M. Aimal Khan, Dr. Najeebullah Tareen, Prof. Dr. Aisha Siddiqa

Abstract

Objectives: To compare short-term outcomes in patients undergoing laproscopic cholecystectomy using low pressure pneumoperitoneum versus normal pressure pneumoperitoneum in patients of cholelithiasis. Methodology: this randomized controlled trial study was conducted at Surgical Department Bolan Medical College from 27th June 2019 to 26th December 2019. A total of 140 patients aged 18-60 years old both males and females with uncomplicated symptomatic gall stones were included. Patients suffering from acute cholangitis, acute biliary pancreatitis, Hep B & C, multiple abdominal surgeries and malignancy were excluded. Group A: low pressure pneumoperitoneum technique was used by keeping the Pressure at 8-10 mmHg. Group B: normal pressure pneumoperitoneum technique was used by keeping the pressure at normal range i.e. 12-15mmHg. All the surgeries were done by consultant surgeon. Operative time in both groups was noted. After cholecystectomy, pain in the patients was observed at 6 hrs using visual analogue pain scale after giving a standard dose of and patients were auscultated for bowel sounds by senior resident at 6 hours to record return of bowel activity. Results: Mean operative time in Group A (low pressure pneumoperitoneum) was 50.71 ± 3.67minutes while in Group B (normal pressure pneumoperitoneum) was 43.06 ± 5.71minutes (p-value=0.0001). Mean post-operative pain in Group A (low pressure pneumoperitoneum) was 2.09 ± 0.70 while in Group B (normal pressure pneumoperitoneum) was 4.0 ± 0.73 (p-value=0.0001). Return to bowel activity in Group A (low pressure pneumoperitoneum) was 8.57% while in Group B (normal pressure pneumoperitoneum) was 2.86% (p-value=0.303). Conclusion: This study concluded that the patients undergoing laparoscopic cholecystectomy using low pressure pneumoperitoneum technique have better outcome than normal pressure pneumoperitoneum technique.

Keywords: laparoscopic cholecystectomy, low pressure Pneumoperitoneum, outcome.