Comparison of postoperative peak expiratory flow in open versus laparoscopic cholecystectomy

The upper abdominal operations change postoperative pulmonary function tests. The postoperative pulmonary function tests are restrictive substantially. Peak Expiratory Flow (PEF) decrease in the restrictive lung disease. Laparoscopy causes physiologic changes in the respiratory system too and diaphragmatic function is impaired extensively after laparoscopy. The factors that cause aggravation of restrictive lung disorders increase postoperative lung complications. In this randomized clinical trial thirty patients were ASA class I, II suffering from chronic cholecystitis due to gall stone allocated randomly into group I (open cholecystectomy with 15 patients) and group II (laparoscopic cholecystectomy with 15 patients). The PEF was measured one day before operation and in recovery room and 24 and 48 hours postoperatively in semisitting position. Collected data was analysed by SPSS. 17 software using t test, chi square test and analysis of variance. A p value <0.05 was considered as significant. No difference was demonstrated between two groups with respect to their gender, age, ASA class, BMI and smoking (p> 0.05). Preoperative PEF in the group I (OC) was 353±34 (lit/min) and in the group II (LC) was 351±39 (lit/min) and without significant difference between groups (p= 0.92). The PEF on recovery, at 24 and 48 hours postoperative showed 52%, 48% and 42% reduction in the group I (OC) and 41%, 27% and 12% reduction in the group II (LC) respectively (p= 0.0001). Pulmonary function after laparoscopic cholecystectomy is impaired extensively but lesser than after open cholecystectomy. Pulmonary function impairment after open cholecystectomy increases till 24 hours after postoperative period but pulmonary function improves extensively 24 hours after operation in laparoscopic cholecystectomy.