Comparative study of low pressure cholecystectomy comorbid conditions in Tertiary Care Center of India

Dr. Rahul Singh; Dr. Ankur Dutt tripathi; Dr. Shashank tripathi; Dr. Lalit kumar

Volume : IX, Issue : IV, April - 2020

Comparative study of low pressure cholecystectomy comorbid conditions in Tertiary Care Center of India

Dr. Rahul Singh, Dr. Ankur Dutt Tripathi, Dr. Shashank Tripathi, Dr. Lalit Kumar

Abstract :

Background: Use of Pnemoperitioneum was first proposed by Olte Goetze of Germany in 1981. Flow rates of insufflator to maintain an adequate pneumoperitoneum is about 6–8 lit/min not to let this pressure rise to more than 12 to 15 mm Hg. Low pressure pneumoperitoneum is feasible for laparoscopic cholecystectomy and minimizes the adverse hemodynamic effect. Material and method: All these patients undergone, a full clinical evaluation (detailed history and examination). A] Low–pressure capnoperitoneum laparoscopic cholecystectomy performed in 35 patients with no comorbid condition–referred as Control. B] Low–pressure capnoperitoneum laparoscopic cholecystectomy performed in 37 patients with comorbid condition–referred as study group. Intraoperative and postoperative assessment of complications done. Observation: Mean blood loss in study group (63.02�14.46) was significantly higher than in control group (49.08�15.26), in study group (61.06�19.83 minutes) was significantly higher than in control group (46.06�19.83 minutes). Conversion rate in control group was 5.7% (2/35), 8.1% (3/37) to open and 2.7% to Standard pressure capnoperitoneum Laparoscopic cholecystectomy in study group. Occurrence of complication during intraoperative period on our series (5.4%). Postoperative nausea and vomiting occurred in 7 (21.2%) and 4 (12.1%) patients of study groups. In study group was 20.60�8.52 hours and in control group it was 24.49�10.03 hours. Quality of life on day 5 was (80.2�4.3) in study groups, (84�4.4) in control group. Postoperative complication rate compares favorably to with postoperative complication rate of 196.3%. Conclusion: Low–pressure capnoperitoneum laparoscopic cholecystectomy is a safe treatment for cholecystitis in obese, elderly, diabetics, cardiac disease, lung disease