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Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic cholecystectomy: a systematic review and
1Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China; Department of General Surgery, First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China.
Background:
The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear.
Methods:
A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed.
Results:
A total of 1,263 patients were included. Low-pressure pneumoperitoneum was associated with significantly decreased postoperative pain. The requirement for increased pressure was significantly greater in the low-pressure group (risk ratio = 6.16; P < .001). Operative time was similar, with only a slight statistical significance (weighted mean difference = 2.07; P < .001). Length of hospital stay was shorter in the low-pressure group (weighted mean difference = -.27; P = .01). No significant differences were found in surgical complications or conversion to open surgery.
Conclusions:
Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative pain and near-equal operative time compared with standard-pressure pneumoperitoneum. More studies are required to investigate the potential benefits of the reduced length of hospital stay.
