Post-Operative Pulmonary Function : A Comparison between Upper Abdominal Open Cholecystectomy and Laparoscopic Cholecystectomy

Abstract

Postoperative Pulmonary Complications (PPCs) is one of the major cause of perioperative mortality and morbidity in thoracic and upper abdominal surgery. Preoperative risk assessment enables clinicians to reduce perioperative risk in high risk patients.. In upper abdominal surgery, there is a larger alteration in pulmonary functions. This study was performed in 30 patients scheduled for laparoscopic cholecystectomy and for upper abdominal open cholecystectomy. The study revealed that after both laparoscopic & open upper abdominal cholecystectomy there was significant alteration of pulmonary function. There was significant alteration at six hours and after operation which then gradually improved, but it took about 24 hours for its complete recovery. The alteration was more evident in open cholycystectomy. Nevertheless these alterations did not cause any clinical derangement as expressed by SpO2, HR, & BP. The study also showed a significant dose reduction of opioid in case of laparoscopic cholecystomy. The lung function at postoperative ward correlated well with the level of analgesia. But persistent alteration of pulmonary function indicated presence of other mechanical factors. Key Words: Surgery-Lap.Cholecystectomy, Surgery- Upper abdominal, Complication-post- Operative, complication-pulmonary, Patient control analgesia Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.12-16DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4045