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Pneumoperitoneum after laparoscopic cholecystectomy: frequency and duration as seen on upright chest radiographs
K Millitz1, D J Moote, R K Sparrow
1Department of Diagnostic Radiology, Victoria Hospital Corporation, London, Ontario, Canada.
Objective:
This study aimed to determine the frequency and duration of pneumoperitoneum after laparoscopic cholecystectomy, as detected on upright chest radiographs.
Materials And Methods:
Fifty-five patients who underwent laparoscopic cholecystectomy were studied prospectively. Upright posteroanterior chest radiographs were obtained 6 hr after surgery (day 1); additional radiographs were obtained on days 2, 4, 7, and 14, if required, until the pneumoperitoneum resolved. A perpendicular measurement of any pneumoperitoneum detected between the diaphragm and the liver was obtained. The pneumoperitoneum was graded as absent, trace (1-5 mm), mild (6-10 mm), or moderate (10-15 mm).
Results:
No evidence of pneumoperitoneum was seen on chest radiographs taken 6 hr after surgery (day 1) in 27 (54%) of the 50 patients who completed the study. Of the remaining 23 patients (46%), all but one showed resolution of the pneumoperitoneum in the first week. Of these 23 patients, 17 showed trace pneumoperitoneum and six showed mild pneumoperitoneum on chest radiographs.
Conclusion:
Despite the use of carbon dioxide gas during laparoscopic cholecystectomy, a significant number of patients have postsurgery pneumoperitoneum that is visible on upright chest radiographs. The pneumoperitoneum resolves in most patients within the first week after surgery.