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The Impact of Intra-abdominal Pressure on Perioperative Outcomes in Laparoscopic Cholecystectomy
Muhammad Attaullah Khan1,2, Ihtisham Haq1,2, Zain Ihsan3
1Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK.
Introduction:
Intra-abdominal pressure (IAP) is a critical factor in laparoscopic cholecystectomy, potentially affecting various perioperative outcomes. Understanding the impact of different IAP levels can guide clinical practice to optimize patient safety and recovery.
Objective:
This study aimed to evaluate the effects of low, moderate, and high IAPs on perioperative outcomes in patients undergoing laparoscopic cholecystectomy.
Methodology:
A total of 150 patients were categorized into three groups based on IAP: Low Pressure (8-10 mmHg, n=50), Moderate Pressure (10-15 mmHg, n=70), and High Pressure (>15 mmHg, n=30). Primary outcomes measured included operative time, intraoperative complications, postoperative pain scores at six hours, length of hospital stay, and return to normal activity. Secondary outcomes included postoperative complications and analgesic consumption.
Results:
Operative time increased significantly with higher IAP, averaging 80.4 ± 12.7 minutes in the Low Pressure group, 85.6 ± 15.3 minutes in the Moderate Pressure group, and 90.1 ± 14.2 minutes in the High Pressure group (p=0.03). Intraoperative complications occurred in 10%, 15%, and 23% of patients in the Low, Moderate, and High Pressure groups, respectively (p=0.12). Postoperative pain scores, length of hospital stay, and recovery time showed no significant differences between groups.
Conclusion:
Higher IAP is associated with longer operative times but does not significantly affect other perioperative outcomes, suggesting that careful consideration of IAP levels is important in laparoscopic cholecystectomy.
