[Incidence of nausea and vomiting after cholecystectomy performed via laparotomy or laparoscopy]

Postoperative nausea and vomiting (PONV) are commonly observed adverse effects of general anesthesia. In a retrospective study of laparoscopy group (101 patient) and laparotomy group (101 patient), we evaluated the incidence of PONV after laparoscopic cholecystectomy. Most factors which could influence the incidence of PONV were not significantly different between the groups. The overall incidence of PONV during the first 17h postoperatively was 25.7% in laparoscopy group and 18.8% for laparotomy group respectively, but the risk was 3.2 times greater in laparoscopy group (15.8%) than in laparotomy group (5.0%) (P < 0.05) during the first postoperative hour. The risk of PONV was greater in laparoscopy group in female patients (23.4% versus 9.3% in laparotomy group, P < 0.05) and in obese patients (25.0% versus 0% in laparotomy group, P < 0.01) during the first postoperative hour. We conclude that laparoscopic cholecystectomy increases the incidence of PONV in early postoperative period probably by the effect of residual stretching and irritation of the peritoneum, and the risk is increased in female and obese patients.