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Postoperative Pulmonary changes after laparoscopic cholecystectomy as measured by Spirometry

Shams ul Bari, Javaid Ahamd Malik, Firdous Ahmad Beigh, Ramees Mohiud din Mir.

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Background: Laparoscopic cholecystectomy compared to open cholecystectomy is associated with less postoperative pain and subsequent less reduction and faster recovery of postoperative pulmonary function.
Objectives: The study aimed to study the changes in spirometric parameters of the patients following laparoscopic cholecystectomy as compared to preoperative values.
Material and Methods: The study entitled “Postoperative Pulmonary changes after laparoscopic cholecystectomy as measured by Spirometry” was conducted in the department of general surgery SKIMS Medical College over a period of two years from June 2016 to May 2018. It was a prospective observational study, and the total number of patients studied was 56. The first pulmonary function test was carried a day before surgery. The second test was carried 48 hours after surgery, while the third test was carried on the 7th postoperative day.
Main outcome measures: The main outcome measures which were studied included Forced vital capacity (FVC), Forced expiratory volume in the first second (FEV1) and Peak expiratory flow rate between 25-75 % (PEFR 25-75%).
Results: Of the total 56 patients under study, 87.5% of patients had normal lung function preoperatively. On the second postoperative day, 32.1% of patients had normal lung function, 58.9% had a restrictive pattern, and 8.9% had an obstructive pattern of lung function. On the seventh postoperative day, 76.8% had normal lung function, 17.9% had a restrictive pattern, while 5.4% had an obstructive pattern.
Conclusion: Laparoscopic surgery causes less pulmonary function impairment and allows a quicker return to the preoperative state.

Key words: Cholecystectomy, obstructive, Pneumoperitoneum, restrictive Spirometry

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