Comparative Study of Low Pressure Pneumoperitoneum versus Standard Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Abstract

Aim: - To evaluate the advantages and disadvantages of low pressure (8mmHg) in comparison to standard

pressure pneumoperitoneum (12mmHg) in laparoscopic cholecystectomy.

Setting & Design: - Prospective study from April 2017 to March 2018 in the Department of General Surgery,

Saraswathi Institute of Medical Sciences, Hapur.

Methods & Material: - A prospective randomized controlled trial incorporating 80 patients with

symptomatic uncomplicated cholelithiasis who underwent laparoscopic cholecystectomy using a four port

technique. All patients were divided randomly in two groups: 40 patients underwent LPLC (Low Pressure

Laparoscopic Cholecystecomy) and another 40 patients underwent SPLC (Standard Pressure Laparoscopic

Cholecystectomy). Factors included in statistical analysis were per-operative pulse, blood pressure, operative

time, post-operative pain including shoulder tip pain, complication rate, conversion rate to SPLC, conversion

rate to open cholecystectomy, postoperative hospital stay.

Statistical analysis: It was done using Chi-square test & Student t test.

Results: - No statistically significant difference was found in hemodynamic changes, postoperative pain

including shoulder tip pain, mean operative time, mean hospital stay in both groups. Conversion from LPLC

to SPLC was done in 4 cases. No case was converted to open cholecystectomy.

Conclusions: - Laparoscopic cholecystectomy can be safely performed at low pressure (8 mmHg)

pneumoperitoneum.