Lung volumes 24 Hours after Laparoscopic Cholecystectomy — Justification for Early Discharge

Abstract

OBJECTIVE: To compare lung volumes after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).DESIGN: Prospective study with matched historical controls.SETTING: Referral teaching hospital.SUBJECTS: Twenty-six healthy female subjects (age 20 to 40 years), 13 of whom had LC.MAIN OUTCOME MEASURES: Vital capacity (VC, % predicted), functional residual capacity (FRC, % predicted) and analgesic frequency (mean ± SD) over the first 24 h.RESULTS: Immediately after operation, FRC was similarly depressed to 80.4±1.8% in the OC group and 80.8±2.3% in the LC group. After 24 h FRC fell to 70.5±1.9% in the OC group and increased to 91.3±2.4% in the LC group. VC fell immediately postoperation to 41.4±4.8% in the OC group but to only 62.2±1.9% in the LC group. By 24 h, VC improved slightly to 52.5±2.7% in the OC group but returned to normal, 99.0±3.2%, in the LC group. Postoperative analgesic frequency over 24 h was less in the LC group, 3.3±0.8 versus 5.0±0.8.CONCLUSION: Depression in lung volume is less with LC. A VC that returned to normal and a FRC level not usually associated with pulmonary complications support the practice of discharging LC patients by 24 h postoperation.