Hemodynamic, respiratory, and metabolic effects of laparoscopic cholecystectomy

Robert L. Goodale, David S. Beebe, Michael P. McNevin, Michael Boyle, Janis G. Letourneau, Jerome H. Abrams, Frank B. Cerra

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

In 10 patients undergoing laparoscopic cholecystectomy, creation of pneumoperitoneum caused immediate venous hypertension and stasis in the lower extremities as measured by percutaneous catheter and duplex scanning. These changes disappeared after deflation. As measured by spirometry, significant reductions in forced vital capacity of 23% and forced expiratory volume in 1 second of 22% were present 24 hours after surgery, and plasma interleukin-6 levels rose to 18 pg/mL. The visual analogue scale of resting pain increased to a median value of 2.5 postoperatively. When compared with other studies of open cholecystectomy, our results showed fewer restrictions of ventilation, lower cytokine levels, and lower pain scores. The minimal soft tissue trauma and early ambulation after laparoscopic cholecystectomy may decrease the risk of thrombosis despite an acute episode of venous stasis.

Original languageEnglish (US)
Pages (from-to)533-537
Number of pages5
JournalThe American Journal of Surgery
Volume166
Issue number5
DOIs
StatePublished - Nov 1993

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