Postoperative pulmonary function after laparoscopic and open cholecystectomy

In this prospective, randomized study, we compared 42 patients undergoinglaparoscopic cholecystectomy and 40 undergoing open cholecystectomy todetermine if laparoscopic cholecystectomy results in less respiratoryimpairment and fewer respiratory complications. Pulmonary function tests,arterial blood-gas analysis and chest radiographs were obtained in bothgroups before operation and on the second day after operation.Postoperative pain scores and analgesic requirements were also recorded.After operation, a significant reduction in total lung capacity, functionalresidual capacity (FRC), forced expiratory volume in 1 s (FEV1), forcedvital capacity (FVC) and mid-expiratory flow (FEF25-75%) occurred afterboth laparoscopic and open cholecystectomy. The reductions in FRC, FEV1,FVC and FEF25-75% were smaller after laparoscopic (7%, 22%, 19% and 23%,respectively) than after open (21%, 38%, 32% and 34%, respectively)cholecystectomy. Laparoscopic cholecystectomy was also associated with asignificantly lower incidence (28.6% vs 62.5%) and less severe atelectasis,better oxygenation and reduced postoperative pain and analgesia usecompared with open cholecystectomy. We conclude that postoperativepulmonary function was impaired less after laparoscopic than after opencholecystectomy.