Postoperative pulmonary changes after laparoscopic cholecystectomy.
BACKGROUND Pulmonary function tests on the day after open upper abdominal surgery and cholecystectomy show decreases of 40% to 60% compared with preoperative determinations. In this prospective, study, we evaluated the pulmonary function during and after laparoscopic cholecystectomy (LC). PATIENTS AND METHODS Thirty patients were evaluated with preoperative and postoperative spirometry, arterial blood gas determinations and chast radiographs to quantitate the magnitude of postoperative pulmonary changes after LC. Spirometry and chast radiographs were made before and 24 h after operation. Blood gas analye were performed preoperative, and 24 h after operation. RESULTS Forced expiratory volume in 1 s (FEV: mean +/- SD values; preoperative: 3.12 +/- 0.78; postoperative: 2.33 +/- 0.80; P < 0.05), forced vital capacity (FVC; preoperative: 3.58 +/- 0.95; postoperative: 2.93 +/- 1.05; P < 0.05), peak expiratory flow (PEF; preoperative: 5.59 +/- 1.97; postoperative: 4.27 +/- 1.60; P < 0.05) and the midexpiratory phase of forced expiratory flow (FEF25-75; preoperative: 1.98 +/- 0.93; postoperative: 1.60 +/- 0.73; P < 0.05), were reduced 20-25% on average compared with preoperative values. Clinically important changes in arterial blodd gas values did not occur. Of 30 postoperative chest films, 9 showed the development of microatetelctasis. CONCLUSION Improved pulmonary function after laparoscopic cholecystectomy may account for the observed reduced rate of pulmonary complication after laparoscopic cholecystectomy.