A simple method of reducing residual intraperitoneal carbon dioxide after laparoscopic cholecystectomy: a...

The aim of the current study was to directly investigate whether active gas suction reduces intraperitoneal residual carbon dioxide and to analyze the effect of active gas suction on postoperative pain after laparoscopic cholecystectomy.

This prospective, randomized clinical study included patients between 19 and 65 years of age with gallbladder disease who were eligible for elective laparoscopic cholecystectomy. Patients were allocated into either the natural evacuation group (NE group) or the active suction group (AS group). In the AS group, active suction was applied by inserting the laparoscopic suction irrigation device through a 5-mm trocar for 60 seconds at the end of surgery. A chest X-ray was taken at postoperative Day 1, and the residual intraabdominal gas volume was measured. Perioperative data including pain score and analgesic requirement were collected.

Thirty-nine patients were allocated to the NE group, and 36 were allocated to the AS group. There was no statistically significant difference between the two groups in terms of demographic data and operative findings. However, a significant difference was observed in the residual intraperitoneal gas volume, with 15.9±6.8 mL in the NE group and 6.7±4.0 mL in the AS group (P<.001). Significant differences were also observed in the pain scores measured 6 hours after surgery, on postoperative Day 1, and on postoperative Day 2.

Active gas suction is a very simple procedure that is safe and feasible. Performing this procedure significantly decreases the residual intraperitoneal gas volume and postoperative pain after laparoscopic surgery.