人工气腹前腹腔灌洗对腹腔镜胆囊切除术后肩痛的疗效分析

目的比较腹腔充入CO₂气体建立人工气腹前、后不同时间段进行腹腔灌洗,对腹腔镜胆囊切除术（LC）术后肩痛的疗效。 方法选择2016年3月至2018年6月南方医科大学附属小榄医院诊治的LC患者120例,按照数字表法随机分为A、B、C组,每组40例。A组为对照组,术后尽量吸尽膈下气体关腹,不进行腹腔灌洗;B组术后用温生理盐水（37.5℃的0.9%氯化钠溶液）进行腹腔灌洗;C组为充入CO₂气腹前先进行膈下温生理盐水灌洗,术后再次行腹腔灌洗。比较3组患者术后6、12、24、48 h的术后肩痛评分（VAS）和中、重度肩痛发生率。 结果3组患者在术后48 h不同时间点的肩痛VAS评分比较及两两比较,差异均有统计学意义（P<0.05）,其中C组的肩痛程度最轻。A、B、C组患者中、重度肩痛发生率分别为27.5%（11/40）、7.5%（3/40）、2.5%（1/40）,整体比较差异有统计学意义（χ²=12.708,P=0.002）,其中A组发生率显著高于B组和C组（χ²=4.242、7.941,P=0.039、0.005）,而B、C两组发生率差异无统计学意义（χ²=0.263,P=0.608）。 结论温生理盐水灌洗腹腔可明显降低LC术后疼痛的发生率和减轻术后肩痛的强度,其中人工气腹前灌洗温生理盐水的患者术后发生肩痛程度最轻。     

不同处理对腹腔镜胆囊切除术后肩部疼痛的影响

观察不同处理对腹腔镜胆囊切除(LC)术后肩部疼痛的影响。选取2013年1月—2015年9月行LC患者135例,根据数字随机表法分成A、B、C 3组,每组各45例。其中A组术毕送入苏醒室,B组右膈下置管引流2h,C组术中右膈下温热生理盐水冲洗。比较3组麻醉时间、手术时间、气腹时间和住院时间,统计术后3d内肩部疼痛发生率,比较术后1h、术后1、3d视觉模拟评分(VAS)。3组麻醉时间、手术时间、气腹时间、住院时间比较,差异均无统计学意义(P0.05)。B、C组肩部疼痛发生率显著低于A组,且C组发生率更低,差异有统计学意义(P0.05)。B、C组术后1h、1d及3d VAS评分均显著低于A组,且C组更低,差异有统计学意义(P0.05)。LC术中通过温热生理盐水冲洗右膈下能够有效预防并改善患者术后肩部疼痛。     

不同压力CO2气腹对腹腔镜胆囊切除术后肩部疼痛发病影响的临床观察

目的研究腹腔镜胆囊切除术 (laparoscopiccholecystectomy ,LC)后肩部疼痛发生的原因、机理及防治方法。方法将 12 0例行LC的患者随机分为A、B、C组 ,每组 4 0例。气腹压力设定A组 10mmHg ,B组 12mmHg ,C组 14mmHg。观察 3组术前、术后的PaO2 、PaCO2 、动脉血 pH值以及术后 1、3、6、12、2 4、4 8、72、96h肩痛的发生率和疼痛程度 (视觉模拟评分 VAS)。结果术中CO2 用量C组较A组多 ,差异有显著意义 (F =11 38,P <0 0 5 )。C组术前、术后的PaO2 差值与A、B组术前、术后PaO2 差值相比较大 ,且差异有显著意义 (F =6 92 ,P <0 0 1)。随 3组气腹压力的增高 ,术后 3、12、2 4、4 8h肩痛发生率有增高趋势 (χ2 值分别为 2 36 6 ,2 32 4 ,2 72 9,2 340 ,P <0 0 5 ) ;其VAS评分也明显上升 (F =19 5 3,P <0 0 1)。结论LC术后肩痛的主要原因可能与人工气腹张力对膈肌的牵拉有关。在 10mmHg低压气腹下行LC ,可显著降低LC术后肩痛的发生率及疼痛程度。     

罗哌卡因对腹腔镜胆囊切除术患者的镇痛效果

目的探讨切口内浸润及胆囊床喷洒盐酸罗哌卡因对腹腔镜胆囊切除术患者术后镇痛效果和安全性。方法选择在全麻下行腹腔镜胆囊切除术患者160例,随机分为4组。A组:在作腹壁切口前切口预定点注入0.75%盐酸罗哌卡因2 mL;B组:手术结束前向胆囊床喷洒盐酸罗哌卡因10 mL;C组:联合应用A/B组的处理;D组:不做任何以上处理。各组在术后均持续监测患者血氧饱和度、呼吸、血压、心电图,记录术后2、6、12、24 h的VAS评分、Ramsay评分和术后额外镇痛药使用情况及副作用发生情况。观察术前30 min、术后180min静脉血皮质醇含量。结果A、B、C三组术后12 h的VAS评分低于D组(P0.05);4组患者各时间点Ramsay评分差异无统计学意义(P0.05);A、B、C三组额外镇痛药使用次数少于D组(P0.05);4组患者副作用发生情况差异无统计学意义(P0.05);A、B、C三组在术后180 min血液中皮质醇含量少于D组(P0.05)。结论罗哌卡因对腹腔镜胆囊切除术患者具有很好的镇痛效果,联合切口处浸润和胆囊床表面喷洒罗哌卡因的效果更佳,具有较好的安全性。     

比较低气腹压和标准气腹压腹腔镜胆囊切除术后患者的恢复效果

目的比较低气腹压和标准气腹压腹腔镜胆囊切除术(LC)术后患者的恢复效果。方法随机将行LG的219例患者分为2组。低气腹压组111例术中维持腹压为7～8 mmHg(1 mmHg=0.133 kPa),标准气腹压组108例术中维持腹压为12～15 mmHg。比较2组患者术后各时点的肩部疼痛发生率、疼痛视觉模拟评分(VAS)及术中术后并发症的发生率。结果 (1)术后4 h、8 h、12 h及24 h,标准气腹压组患者的肩部疼痛率及疼痛VAS评分均高于低气腹压组,差异有统计学意义(P0.05)。(2)2组患者术中术后并发症发生率差异无统计学意义(P0.05)。结论低气腹压下实施LC,可显著降低患者术后肩痛的发生率及疼痛VAS评分,且不会增加并发症发生率,更利于患者术后恢复。     

术前使用罗哌卡因对腹腔镜胆囊切除术后镇痛效应的临床研究

目的:观察腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术前应用罗哌卡因切口浸润结合术中腹腔喷洒对术后疼痛的缓解效应。方法:随机将择期行LC的90例患者分为3组(n=30),A组术前用0.75%罗哌卡因13.3 ml(100 mg)逐层浸润切口并喷洒腹腔;B组术后使用静脉镇痛泵;C组为对照组,使用生理盐水,方法同A组。分别于麻醉苏醒后2 h、6 h、12 h、24 h记录镇痛模拟评分(visual analogue scale,VAS),并记录3组患者使用镇痛药情况。结果:3组患者术后均无并发症发生及相应毒副反应。术后2 h、6 h、12 h,A、B两组患者VAS评分差异无统计学意义(P>0.05),均明显低于C组(P<0.05)。A、B两组各有2例(6.7%)患者应用非甾体类抗炎药,C组11例(36.7%)应用非甾体类抗炎药,差异有统计学意义(P<0.05)。结论:术前罗哌卡因切口浸润结合腹腔内喷洒可明显降低LC术后早期VAS评分,具有良好的镇痛效果,可减少其他镇痛药物的使用量。     

胆囊三角区局部浸润对腹腔镜胆囊切除术患者术后镇痛的安全性及有效性研究

目的:探讨胆囊三角区局部浸润对腹腔镜胆囊切除术(LC)患者术后镇痛的安全性与有效性。方法:选择ASA分级为Ⅰ或Ⅱ级的140例腹腔镜胆囊切除患者,18～64岁,随机分为A组与B组,每组70例。B组于胆囊分离前在胆囊三角区软组织注射1%盐酸罗哌卡因10 mL,A组则予以等容量的0.9%生理盐水。记录两组术后2 h、4 h、6 h、12 h、24 h、48 h静态与动态VAS疼痛评分,以及术后3、6个月静态与动态NRS评分,慢性疼痛发生率。结果:术后2 h、4 h、6 h、12 h、24 h,B组静态与动态VAS评分低于A组,术后48 h动态VAS评分低于A组(P<0.01)。术后139例获得远期随访,术后3个月,A组慢性疼痛发生率为46.38%,内脏痛为33.33%;B组分别为24.29%与14.29%;B组发生率低于A组(P<0.05)。术后6个月,A组慢性疼痛发生率为26.09%,内脏痛为15.94%;B组分别为12.86%与7.14%;B组慢性疼痛发生率低于A组(P<0.05)。结论:罗哌卡因胆囊三角区局部浸润可优化腹腔镜胆囊切除术后患者自控静脉镇痛的效果,有效减轻术后急性疼痛,降低术后慢性疼痛发生率。     

氯胺酮辅以地塞米松术前用药对腹腔镜胆囊切除术后疼痛的影响

目的:探讨氯胺酮在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后超前镇痛作用及地塞米松对氯胺酮超前镇痛的影响。方法:将60例患者随机分为3组(每组20例):A组(氯胺酮组);B组(氯胺酮+地塞米松组);C组(对照组)生理盐水2ml。对术后1h、2h、4h、6h、12h及术后1d、2d、3d切口痛及非切口痛分别进行VAS镇痛评分和术后镇静评分,记录术后不良反应及术后止痛药的需求情况。结果:术后非切口痛及切口痛,A、B组VAS评分均较C组显著降低(P<0.05);而A组与B组相比,术后VAS评分无明显差异(P>0.05)。术后恶心、呕吐发生率B组(20%)与A组(55%)、C组(60%)相比,明显降低(P<0.05);A、C两组间无明显差异(P>0.05);术后需要止痛药的例数A组3例(15%),B组3例(15%),C组9例(45%)(P<0.05)。结论:氯胺酮辅以地塞米松在LC中能减轻术后疼痛,降低术后恶心、呕吐的发生率,具有超前镇痛作用,但地塞米松未使氯胺酮超前镇痛作用增强。     

超声引导下椎板阻滞在腹腔镜胆囊切除术患者围手术期镇痛中的应用

目的观察超声引导下椎板阻滞对腹腔镜胆囊切除术患者围手术期镇痛的安全性和有效性。 方法选取2019年6月至2020年6月民航总医院行腹腔镜胆囊切除术患者60例，按随机数字法将患者分为椎板阻滞组和对照组，每组30例。椎板阻滞组在麻醉诱导前行超声引导下椎板阻滞，对照组直接行麻醉诱导，两组患者的麻醉诱导和术中麻醉管理相同。比较两组入室、气腹前、气腹后10 min、术毕、术后2 h的平均动脉压（MAP）和心率（HR），手术时间及术中镇痛药用量，术后2、6、24 h的视觉模拟评分（VAS），术后24 h内镇痛药用量、使用者比例和恶心呕吐发生率的差异。 结果两组患者入室、气腹前、气腹后10 min、术毕、术后2 h的MAP、HR、手术时间、术中舒芬太尼和瑞芬太尼用量的差异均无统计学意义。与对照组相比，椎板阻滞组患者术后2、6 h的VAS评分降低，差异均有统计学意义（P<0.05）。两组术后24 h VAS评分的差异无统计学意义。与对照组比较，椎板阻滞组术后镇痛药地佐辛用量和使用者所占比例明显减少，差异均有统计学意义（P<0.05）。两组患者术后恶心呕吐发生率的差异无统计学意义。 结论超声引导下椎板阻滞不影响腹腔镜胆囊切除术患者术中血流动力学变化，但能有效缓解术后6 h内的疼痛。     

妇科术后肩痛及手术部位疼痛的临床分析

目的:探讨妇科术后肩痛及手术部位疼痛的现状。方法:序贯纳入手术时间1~3 h的妇科手术患者,严格按各观察时点进行随访,记录患者肩痛及手术部位疼痛评分、补救镇痛及镇痛副反应。双人录入数据;在统计学教研室老师指导下,以开腹组、腹腔镜组进行对比分析。结果:共纳入合格病例201例,其中腹腔镜手术97例,开腹手术104例。腹腔镜组肩痛发生率(33.0%)高于开腹组(11.5%)(P0.01);肩痛程度两组相比差异无统计学意义。腹腔镜手术中左肩痛14例(14.4%),右肩痛7例(7.2%),双肩痛11例(11.3%);肩痛出现时间主要为术后12 h(10.3%)、24 h(17.5%)内,缓解时间主要在术后24 h(8.3%)、48 h(11.3%)、72 h(8.3%)后;其中14例(14.4%)患者肩痛程度超过手术部位疼痛。手术部位疼痛腹腔镜组较开腹组轻,术后2 h(P0.01)、12 h(P0.05)静息NRS评分,72 h活动NRS评分(P0.01)差异均有统计学意义。腹腔镜组术后患者自控镇痛使用率、麻醉恢复室恢复时间、首次肛门排气时间、术后住院时间均少于开腹组(P0.01)。两组术后恶心呕吐发生率、补救镇痛、补救止吐、感染率差异无统计学意义。结论:开腹手术也存在术后肩痛,术后肩痛发生机制尚待进一步探索。虽然腹腔镜手术具有较高的术后肩痛发生率,但其具有患者创伤小、出血少、术后康复快的优点。     

氧气置换对腹腔镜胆囊切除术后肩部疼痛原因的临床研究

目的 研究腹腔镜胆囊切除术（LC）后肩部疼痛发生的原因和机理。方法 将90例行LC的病人随机分为A、B、C3组,每组30例。A组在LC手术结束后不作任何处理。B组在LC结束后吸尽气腹后残余的CO2。C组在LC结束后吸尽残余CO2,再用O2进行3次置换。观察3组术前、术后的PO2、PCO2以及肩痛的发生率和程度。结果 C组术前、术后的PO2差值与A、B2组术前、术后PO2差值相比较大,且差异有显著性意义（P＜0．05）。A组有13例（13/30,43.33%）、B组有8例（8／30,26．67％）、C组有21例（21／30,70％）发生了肩痛（A组与B组比较,P＞0．05;A组与C组比较,P＜0．05;B组与C组比较,P＜0．01）。C组肩痛程度比A、B2组严重。结论 LC术后肩部疼痛的主要原因不是残余CO2对膈肌的直接刺激,而可能是人工气腹张力对膈肌纤维的牵拉造成的。     

CO_2气腹压力对腹腔镜胆囊切除术后肩痛的影响

目的:探讨CO2气腹压力对腹腔镜胆囊切除术后肩痛发生的影响。方法:随机选取行腹腔镜胆囊切除术100例,随机分为两组,每组50例,分别在1.3kPa和2kPa气腹压下行腹腔镜胆囊切除术。对比两组术后肩痛发生率及程度。结果:1.3kPa术后肩痛发生率明显低于2kPa,且多能耐受,程度较轻。结论:在1.3kPa气腹压力下行腹腔镜胆囊切除术不影响手术操作。术后肩痛发生率低,是行腹腔镜胆囊切除术较理想的气腹压。     

不同气腹压力对腹腔镜胆囊切除术后短期并发症的影响

目的：探讨不同CO2 气腹压力对腹腔镜胆囊切除（LC）术后肝功能、动脉血气及对颈肩部疼痛的 影响。 方法：选择行择期LC 术患者120 例,随机分为A,B,C 3 组,每组40 例。A 组气腹压力设置为 10 mmHg（1 mmHg=0.133 kPa）,B 组为12 mmHg,C 组为14 mmHg。对比分析3 组手术前后 肝功能、血气指标及术后1~3 d 恶心呕吐、颈肩部疼痛的发生率。 结果：术前3 组间各参数比较差异无统计学意义（均P>0.05）,但术后3 组间肝功能、血气指标 改变及恶心呕吐、颈肩部疼痛的发生率均有明显差异（均P<0.05）。结果显示,气腹压力越大, 术后肝功能（AST,ALT,TBIL 升高）和血气指标（PCO2 升高,pH,PO2 下降）变化越明显,且 术后颈、肩痛及恶心呕吐发生率越高。 结论：气腹压力对LC 术后肝功能,动脉血气,颈,肩痛及恶心呕吐有明显影响,故术中应尽量降 低气腹压力。     

Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopy

BACKGROUND: Postoperative shoulder-tip pain occurs frequently following laparoscopic cholecystectomy. The aim of this randomized clinical trial was to evaluate the efficacy of a low-pressure carbon dioxide pneumoperitoneum during laparoscopic surgery in reducing the incidence of postoperative shoulder-tip pain. METHODS: Ninety consecutive patients undergoing laparoscopic cholecystectomy were randomized prospectively into low-pressure (group A) and normal-pressure (group B) laparoscopic cholecystectomy groups. Patients in group A (n = 46) underwent laparoscopic cholecystectomy with 9 mmHg carbon dioxide pneumoperitoneum during most of the operation, and those in group B (n = 44) had laparoscopic cholecystectomy with 13 mmHg pneumoperitoneum. Shoulder-tip pain was recorded on a visual analogue pain scale 1, 3, 6, 12, 24 and 48 h after operation. RESULTS: The low-pressure pneumoperitoneum did not increase the duration of surgery. There were no significant intraoperative or postoperative complications in either group. Fourteen patients (32 per cent) in group B and five (11 per cent) in group A complained of shoulder pain (P<0.05). Mean shoulder-tip pain scores at 12 and 24 h and postoperative analgesia requirements were also significantly lower in the low-pressure laparoscopic cholecystectomy group (P<0.001). CONCLUSION: A carbon dioxide pneumoperitoneum pressure lower than that usually utilized to perform laparoscopic surgery reduces both the frequency and intensity of shoulder-tip pain following laparoscopic cholecystectomy.     

Duration of postlaparoscopic pneumoperitoneum

Background: Patients who present with abdominal pain after recent laparoscopic surgery present a diagnostic dilemma when pneumoperitoneum is present. Previous studies do not define the duration of postlaparoscopic pneumoperitoneum. In this study, we attempted to define the duration of laparoscopic pneumoperitoneum and to identify factors which affect resolution time. Methods: We followed 57 patients who underwent laparoscopic cholecystectomy (34), inguinal herniorraphy (20), or appendectomy (three). Serial abdominal films were taken until all residual gas was resolved. Results: Thirty patients resolved their pneumoperitoneum within 24 h; 16 patients resolved between 24 h and 3 days; nine patients resolved between 3 and 7 days; two patients resolved between 7 and 9 days. Mean resolution time for all patients was 2.6 ± 2.1 days. There was no apparent difference in resolution time between the three types of procedures; however, the sample size may be insufficient. Duration of the pneumoperitoneum did not correlate with gender, age, weight, initial volume of CO₂ used, length of time for the procedure, or postoperative complications. Sixteen patients had bile spillage during cholecystectomy which significantly reduced the duration of postoperative pneumoperitoneum (p < 0.008), resulting in a mean resolution time of 1.3 ± 0.9 days. While 14 patients reported postoperative shoulder pain, no correlation was found between the presence or duration of shoulder pain and the extent or duration of pneumoperitoneum. Conclusions: We conclude that the residual pneumoperitoneum following laparoscopic surgery resolves within 3 days in 81% of patients and within 7 days in 96% of patients. The resolution time was significantly less in patients sustaining intraoperative bile spillage during cholecystectomy. There was no correlation found between postoperative shoulder pain and the presence or duration of the pneumoperitoneum. Received: 22 March 1996/Accepted: 12 July 1996     

不同CO2气腹压力对腹腔镜胆囊切除术后肩痛的影响

目的研究不同CO2气腹压力对腹腔镜胆囊切除术(LC术)后肩部疼痛的影响。方法将100例行LC术的患者随机分为两组,每组50例,分别设定气腹压力为1.2kPa(10mmHg)和2kPa(15mmHg)下行LC术。对比两组术后肩部疼痛发生率及程度。结果在1.2kPa下手术组,患者的术后肩部疼痛程度明显低于2kPa手术组,差异有统计学意义(χ2=22.698,P<0.05)。结论LC术后肩部疼痛的主要原因可能与人工气腹张力对膈肌牵拉刺激有关。在10mmHg低压气腹下行LC术,可显著降低LC术后肩部疼痛的发生率及程度。     

Lactate and acid base changes during laparoscopic cholecystectomy

BACKGROUND: The observation of hemodynamic and metabolic impairment related to CO2 pneumoperitoneum and postoperative mesenteric ischemia reports following laparoscopic procedures have raised concern about local and systemic effects of increase intraabdominal pressure during laparoscopic procedures. The present study aims to evaluate the metabolic and acid base responses of using high pressure versus low pressure pneumoperitonium in patients undergoing laparoscopic cholecystectomy in a prospective randomized clinical trial. PATIENTS AND METHOD: 20 ASA I-II patients scheduled for elective laparoscopic cholecystectomy were randomly allocated to one of two study groups; high pressure pneumoperitoneum 12-14mmHg (HPP, n=10) versus low pressure pneumoperitoneum 6-8mmHg (LPP, n=10) undergoing laparoscopic cholecystectomy. Arterial blood gases and lactate levels were determined after induction of anesthesia (before pneumoperitonium), then after 10 min, then 30 min after insufflations and at the end of surgery and 1 hour postoperatively. Nurses in recovery unit reported pain assessment starting postoperatively until 3 hours on a 10mm VAS (0-10). Statistical significant was established at P<0.05. RESULT: Bicarbonate was significantly (P>0.0412) lower in high pressure group at 30 min and 60 min after insufflations. In high pressure group lactate levels increased significantly as compared to low pressure group, (at 30 minutes after the establishment of abdominal pneumatic inflation P<0.006 and remained significantly increased (P<0.001) until the end of surgery and one hour thereafter) (P<0.001). The mean postoperative pain score during second hour (VAS) at HPP group was 7.4 +/- 1.17 which is significantly (P < or = 0.006) higher than pain score in LPP group 5.0 +/- 1.886. Shoulder tip pain was reported in 3 patients in the high pressure group and only one patient in the lower pressure group. Conclusion: High-pressure pneumoperitonium causes statistically significant elevation in the arterial lactate level intraoperatively until one hour post operatively. It also causes higher pain score and shoulder tip pain.     

改良式单孔腹腔镜与传统腹腔镜胆囊切除术临床对比研究

目的通过对改良式经脐入路单孔腹腔镜胆囊切除术(transumbilical single-port laparoscopic cholecystectomy,TSPLC)与传统腹腔镜胆囊切除术(LC)的临床效果对比,研究改良式经脐单孔腹腔镜胆囊切除术在临床应用的安全性、优越性及技术要点。方法回顾性分析我院2014年9月至2016年5月行LC的98例患者(经脐单孔LC组为50例,传统三孔LC组为48例)的临床资料,分别观察并对比两组手术时间、术中出血量、术后疼痛评分、术后止痛药物的使用率、住院时间、切口并发症及切口满意度。结果两组患者均成功完成手术;经脐单孔组手术时间(65.7±13.6)min,传统三孔组(40.2±9.8)min,两者差异有统计学意义(P0.01);经脐单孔组术后6 h疼痛评分(3.83±1.73)及术后止痛药物使用率(8%)均明显低于传统三孔组[术后6 h疼痛评分(4.02±7.5),P=0.025;止痛药物应用率(31.25%),P0.01]。术后患者对切口的满意度,经脐单孔组(95.3±10.78)明显高于传统三孔组(78.57±12.65)(P0.01)。两组术中出血量、术后24 h疼痛评分及术后住院时间比较均无统计学差异(P0.05)。术后随访2~3个月,无胆漏、出血、腹腔积液、切口感染等并发症发生。结论使用改良式经脐入路单孔腹腔镜胆囊切除术安全可行,与传统LC相比具有更加美观、微创,术后恢复快,术后疼痛轻等诸多优势,且不增加手术风险;但该手术操作难度较大,学习曲线相对较长,有一定腹腔镜手术经验的外科医师才能完成。     

Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy

Laparoscopy using carbon dioxide insufflation induces adverse effects in both the cardiovascular and the respiratory function. The use of low pressure pneumoperitoneum has been shown to reduce adverse hemodynamic effects. However, its effect on tissue trauma and postoperative pain and recovery remains controversial. The aim of this study was to compare tissue trauma, postoperative pain, and recovery in two groups of patients undergoing laparoscopic cholecystectomy, one at insufflation pressure of 8 (LC8) and the other at 15 mm Hg (LC15). Forty patients were randomized, 20 in each group. The characteristics of the patients were similar in the two groups. The procedure was completed in all patients in the LC15 group, but in 2 patients in the LC8 group the pressure was increased to 15 mm Hg to complete the operation. There were no significant differences in postoperative pain scores, analgesic consumption, and the incidence of nausea, vomiting, and shoulder pain between the two groups. C-reactive protein concentrations and white blood cell count rose significantly after surgery, but the increase was similar in the two groups. The median duration of surgery was similar, 23 minutes (range 15-65) in the LC8 group and 25 minutes (range 15-80) in the LC15 group. Using our technique of laparoscopic cholecystectomy, there were no advantages to tissue damage, postoperative pain, and recovery when a low pressure pneumoperitoneum was used.