Pulmonary function changes in patients undergoing laparoscopic cholecystectomy

Authors

  • Jaiparam Singh Wazir Department of Surgery, School of Medical Sciences and Research, Sharda University, Uttar Pradesh, India
  • Ashok Kumar Gupta Department of Surgery, School of Medical Sciences and Research, Sharda University, Uttar Pradesh, India
  • Umer Mushtaq Department of Surgery, School of Medical Sciences and Research, Sharda University, Uttar Pradesh, India
  • Rakesh Pandey Department of Surgery, School of Medical Sciences and Research, Sharda University, Uttar Pradesh, India
  • Javid Ahmed Peer Department of Surgery, School of Medical Sciences and Research, Sharda University, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20221154

Keywords:

Pulmonary function, FEV1, FVC, Diaphragm

Abstract

Background: Cholecystectomy, surgical removal of the gallbladder, is one of the most common elective procedures performed by general surgeons.Upper abdominal operations may induce postoperative restrictive ventilatory defects. They are more pronounced in open procedures, yet also seen in laparoscopic ones cholecystectomy.

Methods: This observational study entitled “pulmonary function changes in patients undergoing laparoscopic cholecystectomy” was conducted after clearance from board of studies and ethical committee in the department of general surgery, Sharda hospital, school of medical sciences and research (Greater Noida) during the period 2019-2021. The study population has been calculated by using G-power software with 80% of the power and 5% of the significance level. The total sample size was determined to be 100 patients.

Results: The study population consisted of 34 (34.0%) belonged to 19-30 years. There were 23 (23.0%) males and 77 (77.0%) females among study population. The mean forced vital capacity (FVC) (L), FEV1 (L), FEV1/FVC (%), FEF 25-75 (L) and SpO2 was compared between Pre-operative and post-operative using the paired t test. Mean FVC (L), FEV1 (L), FEV1/FVC (%), FEF 25-75 (L) and SpO2 decreased significantly from pre-operatively to post-operatively.

Conclusions: To conclude my study, it has been observed that pulmonary function variables (FVC, FEV1, FEV1/FVC, FEF-25-75%) were significantly impaired after laparoscopic cholecystectomy.

References

Shahedi WH. The biliary system through the ages. Int Surg. 1979;64:63.

NIH Consensus Conference. Gall stones and laparoscopic cholecystectomy. JAMA. 1993;269:1018-24.

McMahon A, Fishbacher C, Frame S, MacLeod M. Impact of laparoscopic cholecystectomy: a population-based study. Lancet 2000;356:1632-37.

Ribeiro S, Gastaldi AC, Fernandes C. Efeito da cinesioterapia respiratória em pacientes submetidos à cirurgia abdominal alta. Einstein. 2008;6(2):166-9.

Chiavegato LD, Jardim JR, Faresin SM, Juliano Y. Alterações funcionais respiratórias na colecistectomia por via laparoscópica. J Bras Pneumol. 2000;26(2):69-76.

Rademaker BM, Ringers J, Odoom JA, de Wit LT, Kalkman CJ, Oosting J. Pulmonary function and stress response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thoracic epidural analgesia. Anesth Analg 1992;75:318-25.

Schauer PhR, Luna J, Ghiatas AA, Glen ME, Warren JM, Sirinek KR. Pulmonary function after laparoscopic cholecystectomy. Surgery. 1993;144:389-99.

Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med. 1991;324:1073-8.

Chumillas MS, Ponce JL, Delgado F, Viciano V. Pulmonary function and complications after laparoscopic cholecystectomy. Eur J Surg. 1998;164(6):433-7.

Bures E, Fusciardi J, Lanquetot H, Dhoste K, Richer JP, Lacoste L. Ventilatory effects of laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 1996;40(5):566-73.

Beebe DS, McNevin MP, Crain JM, Letourneau JG, Belani KG, Abrams JA, et al. Evidence of venous stasis after abdominal insufflation for laparoscopic cholecystectomy. Surg Gynecol Obstet. 1993;176:443-47.

Barnett RB, Clement GS, Drizin GS, Josselson AS, Prince DS. Pulmonary changes after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1992;2(2):125-7.

McMahon AJ, Rusell IT, Ramsay G. Laparoscopic and minilaparotomy cholecystectomy: a randomized trial comparing postoperative pain and pulmonary function. Surgery. 1994;115:533-9.

Joris J, Cigarini I, Legrand M, et al. Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth. 1992;69:341-5.

Johnson D, Litwin D, Osachoff J, McIntosh D, Bersheid B, Church D, et al. Postoperative respiratory function after laparoscopic cholecystectomy. Surg Laparoscopy Endoscopy. 1992;2:221-6.

Borges MC, Gouvea AB, Marcacini SFB, Oliveira PF, Silva AAD, Crema E. Pulmonary function in women: comparative analysis of conventional versus single-port laparoscopic cholecystectomy. Rev Col Bras Cir. 2018;45(2):e1652.

Gutt CN, Oniu T, Schemmer P, Kraus T, Buchler MW. Circulatory and respiratory complications of carbon dioxide insufflation. Dig Surg. 2004;21:95-105.

Frazee RC, Roberts JW, Okeson GC. Open versus closed laparoseopic cholecystectomy. A comparison of postoperative pulmonary function. Ann Surg. 1991;214:651-4.

Kundra P, Vitheeswaran M, Nagappa M, Sistla S. Effect of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(3):170-2.

Hasukiæ S, Mesiæ D. Postoperative pulmonary changes after laparoscopic cholecystectomy. Med Arh. 2001;55(2):91-3.

Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Postoperative pulmonary function after laparoscopic and open cholecystectomy. Brit J Anaesthesia. 1996;77:448-52.

Freeman JA, Armstrong IR. Pulmonary function tests before and after laparoscopic cholecystectomy. Anaesthesia. 1994;49(7):579-82.

Mahul P, Burgard G, Costes F, Guillot B, Massardier N, El Khouri Z, et al. Postoperative respiratory function and cholecystectomy by laparoscopic approach. Ann Fr Anesth Reanim. 1993;12(3):273-7.

Hall JC, Tarala RA, Tapper J, Hall JL. Prevention of respiratory complications after abdominal surgery: a randomised clinical trial. BMJ. 1996;312:148-53.

Simonneau G, Vivean A, Sartene R. Diaphragm dysfunction induced by upper abdominal surgery. Am Rev Resp Dis. 1983;128(5):899-903.

Craig DB. Postoperative recovery of pulmonary function. Anesth Analg. 1981;60(1):46-52.

Fairshter RD, Williams JH Jr. Pulmonary physiology in the postoperative period. Crit Care Clin. 1987:3(2):287-306.

Grams ST, Ono LM, Noronha MA, Schivinski CI, Paulin E. Breathing exercises in upper abdominal surgery: a systematic review and meta-analysis. Rev Bras Fisioter. 2012;16(5):345-53.

Ford GT, Whitelaw WA, Rosenal TW, Cruse PJ, Guenter CA. Diaphragm function after upper abdominal surgery in humans. Am Rev Respir Dis. 1983;127(4):431-6.

Sen M, Özol D, Bozer M. Influence of preemptive analgesia on pulmonary function and complications for laparoscopic cholecystectomy. Dig Dis Sci. 2009;54(12):2742-7.

Bhat S, Katoch A, Kalsotra L, Chrungoo RK. A Prospective Comparative Trial of Post -Operative Pulmonary Function: Laparascopic versus Open Cholecystectomy. JK Sci. 2007;9(2):83-6.

Saad IAB, Zambom L. Variáveis clínicas de risco préoperatório. Rev Assoc Med Bras. 2001;47(2):117-24.

Hasukie S, Mesic D. Post-operative pulmonary changes after laparoscopic cholecystectomy. Med Arh 2001;55:91-3.

Ravimohan SM, Kaman L, Jindal R, Singh R, Jindal SK. Post-operative pulmonary function in laparoscopic versus open cholecystectomy: Prospective, comparative study. Ind J Gastroenterol. 2005;24(1):6-8.

Gibson GJ, Pride NB, Davis JN, Loh LC. Pulmonary mechanics in patients with respiratory muscle weakness. Am Rev Respir Dis. 1977;115:389-95.

Davis J, Goldman M, Loh L, Casson M. Diaphragm function and alveolar hypoventilation. Q J Med. 1976;45:87-100.

Chuter TA, Weissman C, Starker PM, Gump FE. Effect of incentive spirometry on diaphragmatic function after surgery. Surgery. 1989;105:488-93.

Reeve EB, Nanson EM, Rundle FF. Observations on inhibitory respiratory reflexes during abdominal surgery. Clin Sci. 1951;10:65-87.

Couture JG, Chartrand D, Gagner M, Bellemare F. Diaphragmatic and abdominal muscle activity after endoscopic cholecystectomy. Anesth Analg. 1994;78:733-9.

Mealy K, Gallagher H, Barry M, Lennon F, Traynor O, Hyland J. Physiological and metabolic responses to open and laparoscopic cholecystectomy. Br J Surg. 1992;79:1061-4.

Putensen-Himmer G, Putensen Ch, Lammer H, Lingnau W, Aigner F, Benzer H. Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy. Anesthesiology. 1992;77:675-80.

Rademaker BM, Ringers J, Odoom JA, de Wit LT, Kalkman CJ, Oosting J. Pulmonary function and stress response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thoracic epidural analgesia. Anesth Analg. 1992;75:318-25.

Putensen-Himmer G, Putensen C, Lammer H, Lingnau W, Aigner F, Benzer H. Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy. Anesthesiology. 1992;77:675-80.

Celli B. Respiratory muscle strength after abdominal surgery. Thorax. 1993;48(7):683-4.

Paschoal IA, Pereira MC. Abordagem pré-operatória do paciente pneumopata- riscos e orientações. Rev Soc Cardiol Estado de São Paulo. 2000;10(3):293-302.

Damiani G, Pinnarelli L, Sammarco A, Sommella L, Francucci M, Ricciardi W. Postoperative Pulmonary Function in Open versus Laparoscopic Cholecystectomy: A Meta-Analysis of the Tiffenau Index. Dig Surg 2008;25:1-7.

Osman Y, Fusun A, Serpil A, Umit T, Ebru M, Bulent U, et al. The comparison of pulmonary functions in open versus laparoscopic cholecystectomy. J Pak Med Assoc. 2009;59(4):201-4.

McMahon AJ, Rusell IT, Ramsay G. Laparoscopic and minilaparotomy cholecystectomy: a randomized trial comparing postoperative pain and pulmonary function. Surgery. 1994;115:533-9.

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Published

2022-04-26

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Original Research Articles