Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

Koivusalo, Anna-Maria; Péré, P.; Valjus, M.; Scheinin, Tom

doi:10.1007/s00464-007-9300-2

Cited by 48 publications

(31 citation statements)

References 24 publications

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“…In spite of the precautions, one patient had bled profusely from an open sinus in liver bed and had to be converted. Similar results have been cited by other authors previously [8][9][10][11].…”

Section: Discussionsupporting

confidence: 92%

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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Laparoscopic cholecystectomy has revolutionized the management of symptomatic gallstone disease since its introduction more than 20 years ago. It has gained widespread acceptance and is presently the gold standard for its management. This large study spanned over last 10 years and includes prospective data on 950 elective cases of laparoscopic cholecystectomy since 2002. All cases were operated personally by the author in different teaching hospitals of West Bengal. The following were looked into: profiles of the patients including major comorbidities requiring special precautions, the frequency of "difficult cholecystectomies," conversion rate, and operative and postoperative complications. The results showed that 75 % of the patients were females. The mean age of the female patients was 35 years (range15-75), while that of the male patients was 42 (range 18-68). Thirty-two patients had major comorbidities which required special precautions in the perioperative period. Twenty-six percent of the cases were categorized as "difficult," and 6 % of the cases had to be converted to open procedure. Major complications occurred in 11 patients of which five had to be converted. Fiftyfive patients had port-site infection due to atypical mycobacteria species of which majority occurred in the last 1 year of the study. All of them responded to second-line antitubercular medications.

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Section: Discussionsupporting

confidence: 92%

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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“…Mimica et al (34) reported that the open technique was associated with a higher risk of anesthesia-related complications in the postoperative period as compared to LC. Koivusalo et al (35) reported that pneumoperitoneum was not associated with an additional risk in ASA III and ASA IV elderly patients during LC. Luo et al (36) concluded that LC is beneficial for restoration of stress hormones, nitrogen balance, and energy metabolism but that it may also cause acidemia and pulmonary hypoperfusion due to pneumoperitoneum.…”

mentioning

confidence: 98%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

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“…For example, the beneficial effects of low-pressure procedures on liver function were demonstrated in some studies (13)(14)(15). However, some studies showed the side effects of low-pressure and standardpressure pneumoperitoneum in laparoscopic cholecystectomy on different organs are comparable (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Nematihonar¹,

Fahimihanzaei²,

Kamranmanesh³

et al. 2017

Ann Anesth Crit Care

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Background: Low-pressure pneumoperitoneum during laparoscopic surgeries decreases some side effects related to inflate gas into abdominal cavity. The current study aimed at comparing the effects of standard-and low-pressure pneumoperitoneum on shoulder pain, nausea, and vomiting after laparoscopic cholecystectomy. Methods: In a randomized clinical trial, 202 ASA classes I and II patients, candidates for elective laparoscopic cholecystectomy, were randomly divided into the groups of standard-(12 to 14 mmHg) and low-(6 to 7 mmHg) pressure pneumoperitoneum. Postoperative shoulder pain, nausea, and vomiting were assessed between the 2 groups. Results: Post-operative shoulder pain was statistically lower in low-pressure group in comparison with standard-pressure group (P = 0.001). Nausea and vomiting were not statistically different between the 2 groups (P = 0.54). Conclusions: Low-pressure pneumoperitoneum during laparoscopic cholecystectomy was an efficient method to decrease postoperative shoulder pain.

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Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

Abstract: For LC for patients with an ASA 3 and 4 risk for anesthesia, no significant adverse effects could be attributed to CO(2 )pneumoperitoneum. For high-risk patients, preoperative preparation and active perioperative monitoring are essential for safe anesthesia for LC with or without CO(2)PP.

Cited by 48 publications

References 24 publications

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

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