Haemodynamic and ventilatory changes during laparoscopic cholecystectomy in elderly ASA III patients

Abstract

We conclude that gradual abdominal insufflation to 12 mmHg followed by a limited 10 degrees head-up tilt is associated with cardiovascular stability in elderly ASA III patients.

Thrombosis of the splenoportal axis after splenectomy

“…Both stases of venous flow and resulting congested coagulation factors may induce PSVT, as reported by Baixauly et al [40]. Nevertheless, we perform laparoscopic procedures with not more than 12 mmHg pneumoperitoneum and considering normal portal pressure near 10-12 mmHg, significant hemodynamic variation should not occur in these conditions [41]. According to our experience, no differences of incidence of PSVT could be found between the two groups of patients.…”

Acute gallstone cholecystitis in the elderly

“…Several authors [35,39] have reported that LC with intraoperative hemodynamic monitoring can be safely performed in elderly patients; however, it is important to use the gasless technique [26] or a gradual abdominal insufflation with a pressure always <12 mmHg and a limited 10°head-up tilt [9].…”

Laparoscopic vs open colectomy for sigmoid diverticulitis

“…Recent studies have focused on adverse effects, including hemodynamic and ventilatory risk during laparoscopy, mainly in patients undergoing laparoscopic cholecystectomy [1,3,6,8,9]. These risks may be higher for older patients.…”