Influence of pneumoperitoneum pressures in laparoscopic cholecystectomy: A clinical trial.

Abstract

Objective: To compare the severity of postoperative abdominal pain between high (12mmHg) vs low (8mmHg) pressure pneumoperitoneum in patients undergoing elective laparoscopic cholecystectomy. Study Design: Prospective, Randomized, Double-blinded Controlled Trial. Setting: Surgical Unit of Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences in Pakistan. Period: Six Months, from 1^st May to 30^th November 2024. Methods: Was carried out involving patients undergoing laparoscopic cholecystectomy (LC) with ethical approval obtained beforehand. Sixty patients participated and were randomly allocated to two groups in equal numbers. Group A underwent LC using high-pressure pneumoperitoneum (12–14 mmHg), whereas Group B had the procedure performed under low-pressure pneumoperitoneum (8–10 mmHg). The level of postoperative pain was assessed using the Visual Analogue Scale (VAS) 24 hours after surgery. Results: The mean age of Group A was 41 ± 9.96 years, and Group B was 38 ± 10.09 years. Group A included 18 (60%) males and 12 (40%) females, whereas Group B had 20 (67%) males and 10 (33%) females. At 24 hours postoperatively, 22 (73%) patients in Group A experienced mild pain, while 8 (27%) reported moderate-to-severe pain. In Group B, 26 (87%) patients had mild pain, whereas only 4 (13%) experienced moderate-to-severe pain. Conclusion: The article concludes that lower pneumoperitoneum pressures used during laparoscopic cholecystectomy reduced post-operative pain in comparison to when higher pressures were used without compromising the operative visibility. Future studies require larger sample size studies to address further the concerns for surgical visibility, operative duration, while also assessing the outcomes.