Routine low-pressure pneumoperitoneum during laparoscopic cholecystectomy.
Pneumoperitoneum at 15 mmHg results in dangerous hemodynamic disturbances in some patients. The use of low-pressure insufflation may make laparoscopic surgery safer. Data were collected prospectively from a consecutive series of patients who had undergone an elective laparoscopic cholecystectomy (LC) by the same surgeon, during the years 1993-94 (group 1, 77 patients) and 1996 (group 2, 50 patients). The groups were similar with respect to age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) grade, existence of abdominal scars due to previous surgery, and severity of gallbladder disease. Patients underwent LC with a mean intraabdominal pressure of 10.56 mmHg in group 1 and 7 mmHg in group 2, respectively. The mean operative time was 75 min and 78 min in groups 1 and 2, respectively (NS). Insertion of an additional cannula was required more frequently (24% versus 14%; NS) in group 2. There were no conversions in either group. The morbidity rate and the postoperative hospital stay were similar for both groups. LC can be performed routinely at low intraabdominal pressure, which may contribute to the safety and comfort of the procedure.