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A Randomized Trial of Low-Pressure (08–10 mm Hg) vs. Standard-Pressure (13–15 mm Hg) Pneumoperitoneum in Laparoscopic Cholecystectomy

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Abstract

The reported incidence of shoulder tip pain after laparoscopic cholecystectomy was 30%–50%. The aim of the present randomized controlled study was to compare the effects of low-pressure (08–10 mm Hg) vs. standard-pressure (13–15 mm Hg) pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. One hundred patients between 18 and 70 years undergoing laparoscopic cholecystectomy were included. Group A and group B patients underwent low-pressure and standard-pressure pneumoperitoneum laparoscopic cholecystectomy respectively. Post-operative shoulder tip pain and post-operative abdominal pain were measured using visual analogue scale score at 2 h, 8 h, 24 h and 48 h after surgery. The primary outcome measures were the incidence and severity of post-operative shoulder tip pain, whereas secondary outcome measures were the incidence and severity of abdominal pain. Intergroup comparison of categorical and continuous variables was done using the chi-square test/Fisher’s exact test and unpaired ‘t’ test respectively. The incidence and severity of post-operative shoulder tip pain at 2 h, 8 h, 24 h and 48 h was significantly higher in group B as compared to group A. The incidence of post-operative abdominal pain at 48 h was significantly higher in group B as compared to group A. The severity of post-operative abdominal pain at 24 h and 48 h was significantly higher in group B as compared to group A. Low-pressure laparoscopic cholecystectomy significantly decreases the incidence and severity of post-operative shoulder tip and abdominal pain. Routine use of low-pressure pneumoperitoneum for the alleviation of post-operative pain following laparoscopic cholecystectomy is recommended.

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Authors and Affiliations

  1. Department of Surgery, Poona Hospital and Research Centre, Pune, 411 030, India

    Tushar Morey

  2. Department of Research, Poona Hospital and Research Centre, Pune, India

    Deepak Phalgune

  3. HoD, Department of Laparoscopic Surgery, Poona Hospital and Research Centre, Pune, India

    Shashank Shah

Authors
  1. Tushar Morey
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  2. Deepak Phalgune
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  3. Shashank Shah
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Contributions

Author 1: Research design, acquisition of data, analysis of data, interpretation of data, revising critically, approving the submitted version.

Author 2: Research design, analysis of data, interpretation of data, drafting the paper, revising critically, approving the submitted version.

Author 3: Research design, interpretation of data, revising critically, approving the submitted version.

The manuscript has been read and approved by all the authors, that the requirements for authorship as stated earlier in this document have been met and that each author believes that the manuscript represents honest work.

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Correspondence to Tushar Morey.

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Morey, T., Phalgune, D. & Shah, S. A Randomized Trial of Low-Pressure (08–10 mm Hg) vs. Standard-Pressure (13–15 mm Hg) Pneumoperitoneum in Laparoscopic Cholecystectomy. Indian J Surg 84, 117–123 (2022). https://doi.org/10.1007/s12262-021-02846-7

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  • DOI: https://doi.org/10.1007/s12262-021-02846-7

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