Potential Pulmonary Benefit of Low Pressure Laparoscopic Cholecystectomy in Selected Patients

Peking Union Medical College Hospital140 enrolled

Overview

Standard Pressure Laparoscopic Cholecystectomy，as the standard for cholecystectomy, can lead to about 15% of pulmonary atelectasis. According to literature, low pressure laparoscopic cholecystectomy is thought to probably decrease cardio-pulmonary related complications and postoperative pain. However, the previous studies have presented controversial results. Our study aim to evaluate the potential pulmonary benefit of low pressure laparoscopic cholecystectomy in elderly or patients accompanied with cardio-pulmonary disorders.

Standard Pressure Laparoscopic Cholecystectomy, SPLC；12-16mmHg，as the standard for cholecystectomy, can lead to about 15% of pulmonary atelectasis. According to literature, Low Pressure Laparoscopic Cholecystectomy, LPLC；8-10mmHg is thought to probably decrease cardio-pulmonary related complications and postoperative pain. However, most of the existing study have combined population with all age scale, bringing bias to the result. Our study aim to evaluate the potential pulmonary benefit of low pressure laparoscopic cholecystectomy in elderly or patients accompanied with cardio-pulmonary disorders.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

140

Conditions

Cholecystitis/Cholelithiasis Cholecystitis; Gallstone

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Aged 18-85; 2. Patients receiving laparoscopic cholecystectomy due to benign gallbladder diseases; 3. Older patient or accompanied by cardiopulmonary diseases (age\>60 years, hypertension, Diabetes Mellitus, coronary heart disease, arrhythmia, chronic bronchitis, emphysema, history of heart surgery, history of lung surgery, history of mediastinal surgery, asthma, et al); 4. Aged older than 60, with or without the above diseases; 5. American society of Aneshesiologists (ASA) II or higher; 6. Informed consent acquired. Exclusion Criteria: 1. Having contraindication of laparoscopic operations; 2. History at epigastric surgery. -

Outcomes

Primary Outcomes

Change of partial pressure of carbon dioxide（pCO2）

Change of pCO2 in arterial blood gas test

Time frame: Within postoperative 30 days.

Secondary Outcomes

operation time

skin to skin operative duration

Time frame: During surgery.

conversion rate to open surgery

Need of conversion to open surgery duo to adhesion, hemorrhage, or other reasons.

Time frame: During surgery.

visual analogue scale (VAS)

For evaluation of postoperative pain degree, using VAS, scoring 1-10 scores.

Time frame: During postoperative 24 hours.

complication rate

Rate of total postoperative complications