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Lung volumes 24 h after laparoscopic cholecystectomy--justification for early discharge
Objective:
To compare lung volumes after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).
Design:
Prospective study with matched historical controls.
Setting:
Referral teaching hospital.
Subjects:
Twenty-six healthy female subjects (age 20 to 40 years), 13 of whom had LC.
Main Outcome Measures:
Vital capacity (VC, % predicted), functional residual capacity (FRC, % predicted) and analgesic frequency (mean +/- SD) over the first 24 h.
Results:
Immediately after operation, FRC was similarly depressed to 80.4 +/- 1.8% in the OC group and 80.8 +/- 2.3% in the LC group. After 24 h FRC fell to 70.5 +/- 1.9% in the OC group and increased to 91.3 +/- 2.4% in the LC group. VC fell immediately postoperation to 41.4 +/- 4.8% in the OC group but to only 62.2 +/- 1.9% in the LC group. By 24 h, VC improved slightly to 52.5 +/- 2.7% in the OC group but returned to normal, 99.0 +/- 3.2%, in the LC group. Postoperative analgesic frequency over 24 h was less in the LC group, 3.3 +/- 0.8 versus 5.0 +/- 0.8.
Conclusion:
Depression in lung volume is less with LC. A VC that returned to normal and a FRC level not usually associated with pulmonary complications support the practice of discharging LC patients by 24 h postoperation.