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Table of Contents
Vol. 67, No. 2, 2000
Issue release date: March – April
Section title: Clinical Investigations
Respiration 2000;67:153–158
(DOI:10.1159/000029479)

Laparoscopic and Laparotomic Cholecystectomy: A Randomized Trial Comparing Postoperative Respiratory Function

Mimica Ž.a · Biočić M.a · Bačić A.b · Banović I.c · Tocilj J.d · Radonić V.a · Ilić N.a · Petričević A.a
Departments of aSurgery, bAnesthesiology and Intensive Care, cGynecology, and d Pathophysiology, Split University Hospital, Split, Croatia

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Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: April 07, 2000
Issue release date: March – April

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES

Abstract

Background: The fact that pulmonary complications occur in 20–60% of the patients subjected to abdominal operations clearly indicates that the lungs are the most endangered organ during the postoperative period. Objective: The aim of this study was to demonstrate the impact of cholecystectomy on postoperative respiratory disturbances by comparing the laparotomic cholecystectomy with laparoscopic gallbladder removal. Patients and Methods: A hundred cholecystectomized patients were included in the prospective randomized clinical trial. Half of the patients were operated on by the laparotomic procedure, whereas the other half underwent laparoscopic cholecystectomy. Spirometric parameters, arterial blood gases, and acid-base balance were determined before the operation, and at 6, 24, 72 and 144 h postoperatively. Abdominal distension was assessed by auscultating intestinal peristaltics, abdominal circumference measurement, and time interval to restitution of defecation. Results: Six hours postoperatively, the values of ventilation parameters decreased on average by 40–50% from the baseline preoperative values in both groups of patients. The group of patients submitted to laparotomic cholecystectomy had significantly lower spirometric values and slower recovery of the ventilation parameters than the laparoscopic cholecystectomy group. Abdominal circumference was significantly greater and the time needed for restitution of peristaltics and defecation was significantly longer in the laparotomic cholecystectomy group compared to the group of laparoscopic cholecystectomy. Conclusions: Statistically significant impairments including hypoxia, hypocapnia and hyperventilation were observed in the patients submitted to laparotomic cholecystectomy, indicating the presence of objective respiratory risk, especially in elderly patients and patients with obstructive pulmonary diseases or cardiac insufficiency.

© 2000 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: April 07, 2000
Issue release date: March – April

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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