A Prospective Comparative Study on Postoperative Spirometry in Patients Undergoing Laparoscopic Cholecystectomy versus Laparoscopic Appendicectomy

Abstract

Background: Laparoscopic procedures are now the norm in abdominal surgery because of their minimally invasive techniques and attendant advantages. Postoperative pulmonary dysfunction still poses a problem, though, particularly after upper abdominal surgery. This investigation contrasts pulmonary function alteration after elective laparoscopic cholecystectomy and laparoscopic appendicectomy. Methods: A prospective observational study was conducted at Rajiv Gandhi Government General Hospital, Chennai, from March to June 2015. Forty adult patients (ASA Grade I/II, BMI <30 kg/m²) undergoing elective laparoscopic cholecystectomy (Group CHOLE, n=20) or laparoscopic appendicectomy (Group APPEND, n=20) were evaluated. Spirometry (FVC, FEV1, PEFR) was performed preoperatively, and at 6 and 24 hours postoperatively. Pain was monitored using a Visual Analog Scale. Data were analysed using SPSS v16, with significance set at p<0.05. Results: At 6 hours post-op, Group CHOLE showed significantly greater reductions in FVC (26.47% vs 16.54%, p=0.0006), FEV1 (25.30% vs 16.58%, p=0.0033), and PEFR (24.36% vs 16.17%, p=0.0007) compared to Group APPEND. At 24 hours, partial recovery was observed in both groups, but Group CHOLE continued to show more pronounced deficits. Duration of pneumoperitoneum was longer in Group CHOLE (80.6 Vs 71.15 minutes, p = 0.0027). Conclusion: Laparoscopic cholecystectomy, produces more and prolonged post operative pulmonary dysfunction than low abdominal laparoscopic appendicectomy. This indicates the vital role of spirometry and respiratory physiotherapy, particularly in high abdominal operations, to enhance recovery and minimize complications.