Femoral Vein Stasis During Laparoscopic Cholecystectomy Effect of an Intermittent Sequential Pneumatic Compression Device

Abstract

Background: During laparoscopic cholecystectomy (LC), venous stasis of the legs may occur which cannot be prevented by a graded compression bandage used for a standard laparotomy. In this study, we investigated whether femoral vein stasis during LC could be prevented using an intermittent sequential pneumatic compression device (IPC).Methods: The effects of an IPC on blood flow in the legs prior to pneumoperitoneum (baseline), at pneumoperitoneum, at postural change and at deflation were examined by color Doppler ultrasonography on each of two groups, namely the patients without an IPC on the lower extremities (group 1, n = 20) and the patients with an IPC (group 2, n = 20).Results: The peak femoral vein velocity in group 1 at a pneumoperitoneum pressure of 10 mmHg in the reverse Trendelenburg's position was significantly decreased to 29.3 ± 3.4% of the baseline value (P < 0.05). However, in group 2, the velocity was maintained and there was no significant decrease. The blood flow velocity when the IPC was used significantly differed from that when the IPC was not used (P < 0.01). The area of the femoral vein in group 1 at a pneumoperitoneum pressure of 10 mmHg in the reverse Trendelenburg's position significantly increased to 379.5 ± 16.3% of the baseline value (P < 0.05). In group 2, it significantly increased to 387.0 ± 19.1% (P < 0.05). However, the area of the femoral vein when the IPC was used did not significantly differ from that when the IPC was not used.Conclusion: The use of an IPC maintained the peak femoral vein velocity even under pneumoperitoneum and in the reverse Trendelenburg's position.