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Safety and Efficacy of Low-Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy: A Prospective Observational
Debiprasad Sahoo1, Harsh J Barot1, Nitin Borle1
1General Surgery, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, IND.
Introduction:
Conventional laparoscopic cholecystectomy uses pneumoperitoneum pressures of 12-15 mmHg, which may contribute to postoperative pain and physiological disturbances. This study evaluates the safety and efficacy of low-pressure pneumoperitoneum (LPP, 7-10 mmHg) in laparoscopic cholecystectomy.
Materials And Methods:
In this prospective observational study conducted at a tertiary care center, 70 patients undergoing elective laparoscopic cholecystectomy were enrolled. Patients were operated on using LPP; conversions to standard-pressure pneumoperitoneum (SPP) or open surgery were recorded along with intraoperative and postoperative outcomes. Pain scores, operative time, complications, hemodynamics, and hospital stay were assessed.
Results:
The mean age was 40.02 years with female predominance (78.6%). Conversion to SPP occurred in patients with higher mean arterial pressures and larger common bile duct diameters. The 10 mmHg group had significantly shorter operative times (mean: 79.6 min) than the 12 mmHg (113.1 min) and 14 mmHg (140 min) groups. Postoperative pain scores were significantly lower in the LPP group across all time intervals. The majority of patients (64.3%) were discharged within 24 hours. No significant complications or mortality occurred.
Conclusions:
LPP is a safe and effective approach in laparoscopic cholecystectomy, associated with shorter operative times, reduced pain, and faster recovery. It can be considered as a feasible alternative to SPP in appropriately selected patients.
