Pulmonary changes after laparoscopic cholecystectomy

Laparoscopic cholecystectomy has become a widely used procedure. Upper abdominal surgery and particularly open cholecystectomy are known to be associated with marked declines in lung volume and a high risk of postoperative pulmonary complications. The pulmonary effects of laparoscopic cholecystectomy have not yet been studied. We prospectively evaluated 22 patients admitted for laparoscopic cholecystectomy for lung volume changes and development of postoperative pulmonary complications. The procedure was associated with a marked decline in forced vital capacity (FVC, 41.2 +/- 20.7%) and forced expiratory volume in one second (FEV1, 41.4 +/- 20.8%) in the immediate postoperative period. There was no significant difference in loss of lung function according to age (p = 0.18), sex (p = 0.33), or smoking history (p = 0.58). Despite the marked loss in lung function in the immediate postoperative period, no major pulmonary complications occurred. We conclude that laparoscopic cholecystectomy, although associated with early loss of lung function, is a safe and effective procedure with an incidence of postoperative pulmonary complications much less than with open cholecystectomy.