Effects of non-pneumoperitoneum laparoscopic cholecystectomy on respiratory and circulatory system and postoperative complication
2011
Objective To investigate the effects of non-pneumoperitoneum laparoscopic cholecystectomy on respiratory and Circulatory system and postoperative complication.Methods Sixty patients (ASA grade Ⅰ or Ⅱ ) scheduled for selective laparoscopic cholecystectomy,were randomly divided into group A and B with 30 cases each.Group A is non-pneumoperitoneum group,Group B is pneumoperitoneum group.After induction of anesthesia,ventilation was performed with tidal VT 10 ml/kg,respiratory rate (RR) 12 breaths per minute (BPM),ratio of inspiratory to expiratory (I:E) was 1:2.The time of 10 min after entering operating room as T0,The time of operation begining as T1,The time of 15 min after starting operation as T2 in group A,The time of 15 min after making Carbon dioxide pneumoperitoneum as T2 in group B,The time of 5 min after taking out of gallbladder or relieve pneumoperitoneum as T3.To collect blood for laboratory examination at T0,T1,T2,T3 respectively,and record vital sign.Results Compared with group A,Group B have lower PaO2 and higher end-tidal pressure of carbon dioxide,systolic blood pressure,diastolic blood pressure,mean arterial blood pressure and peak pressure of airway (P<0.05).The incidence of shoulder soreness and cut pain was lower in group A (P<0.05).The recovery of bowel tones were faster in group A (P<0.05).Conclusion Compared with pneumoperitoneun laparoscopic cholecystectomy,non-pneumoperitoneum laparoscopic cholecystectomy maintained a steady circulation which more conducive to the oxygenation.And the recovery of gastrointestinal tract functions were faster.
Key words:
Laparoscopic Cholecystectomy; Non-pneumoperitoneum; Carbon dioxide pneumoperitoneum; Complication
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