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Effects of laparoscopic cholecystectomy on lung function: a systematic review
George D Bablekos1, Stylianos A Michaelides1, Antonis Analitis1
1George D Bablekos, Konstantinos A Charalabopoulos, Department of Experimental Physiology, Medical School, Democritous University of Thrace, 68100 Alexandroupolis, Greece.
World Journal of Gastroenterology
|December 18, 2014
Summary
Laparoscopic cholecystectomy causes less lung function impairment than open surgery. This minimally invasive approach preserves spirometry, arterial blood gases, and respiratory muscle function post-operation.
Area of Science:
- Pulmonology
- Surgical Innovation
- Respiratory Physiology
Background:
- Cholecystectomy is a common surgical procedure.
- Traditional open cholecystectomy (OC) can lead to significant postoperative pulmonary complications.
- Laparoscopic cholecystectomy (LC) is a less invasive alternative with potential benefits for respiratory function.
Purpose of the Study:
- To systematically review and integrate evidence on the impact of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) on lung function.
- To compare the effects of LC and OC on spirometry, blood gases, respiratory muscle performance, and breathing control.
Main Methods:
- A comprehensive literature review of studies published over 24 years comparing LC and OC.
- Meta-analysis of 34 articles to quantify the impact on lung function parameters.
- Evaluation of literature quality based on citations and journal impact factors.
- Statistical comparison of postoperative values (as percentages of preoperative) using the Mann-Whitney test.
Main Results:
- Laparoscopic cholecystectomy (LC) showed significantly better preservation of spirometric values (FVC, FEV1, FEF25%-75%) compared to open cholecystectomy (OC) 24 hours post-surgery.
- Postoperative reductions in partial pressure of oxygen (PaO2) were significantly less pronounced after LC than OC.
- LC demonstrated a lesser impact on respiratory muscle strength (maximal respiratory pressures) and breathing control parameters compared to OC.
Conclusions:
- Laparoscopic cholecystectomy is associated with significantly less postoperative impairment of lung function compared to open cholecystectomy.
- The findings support LC as a lung-function-sparing alternative to OC.
- Minimally invasive approaches like LC may reduce the risk of pulmonary complications following cholecystectomy.
