A prospective double-blinded randomized controlled trial comparing systemic stress response in Laparoascopic cholecystectomy between low-pressure and standard-pressure pneumoperitoneum.

Abstract

INTRODUCTION:

Laparoscopic cholecystectomy (LC) has become the gold-standard treatment for gallstone diseases. However, despite huge reduction in operative injury, systemic stress response remains high. This randomized controlled trial (RCT) aimed to compare systemic stress response between 2 different techniques of CO2 pneumoperitoneum.

METHODS:

Trough a prospective, double-blinded RCT, serum levels of cortisol, adrenaline, glucose, and C-reactive protein (CRP) were compared between the two groups consisted of 50 patients undergoing LC under low-pressure and standard-pressure CO2 pneimoperitoneum.

RESULTS:

A total of fifty patients undergoing LC were equally assigned to 2 groups of twenty five patients. Average age was 48 ± 13.8 years (range, 19-74 years). Operative time was similar between standard-pressure group (47.8 ± 16.8 min) and low-pressure group (53.6 ± 25.1). Moreover, intra-operative IV volume administration and urine output did not differ significantly between the 2 groups (p > 0.05). Although the average heart rate and mean arterial pressure were slightly higher in a standard-pressure group compared with a low-pressure group, serial measurements of these parameters were statistically similar between the 2 groups. Serial changes of serum levels of cortisol, glucose, adrenaline, and CRP were compared between surgery day, postoperative 6-h and 1st postoperative day, which did not differ significantly between the standard-pressure and the low-pressure groups (p > 0.05).

CONCLUSION:

Our study did not reveal any alteration in systemic stress response with reduction in intra-abdominal pressure of pneumoperitoneum in LC. RCT REGISTRATION: irct.ir ID: IRCT201110072982N5.

• Authors: Saeed Shoar, Mohammad Naderan, Hossein Ebrahimpour, Ahmadreza Soroush, Shirzad Nasiri, Ali Movafegh, Zhamak Khorgami
• Journal: International journal of surgery (London, England) (Int J Surg) Vol. 28 Pg. 28-33 (Apr 2016) ISSN: 1743-9159 [Electronic] England
• PMID: 26892713 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Blood Glucose
• C-Reactive Protein
• Hydrocortisone
• Epinephrine

Topics

• Abdomen (physiopathology)
• Adult
• Aged
• Blood Glucose (metabolism)
• C-Reactive Protein (metabolism)
• Cholecystectomy, Laparoscopic (adverse effects, methods)
• Double-Blind Method
• Epinephrine (blood)
• Female
• Humans
• Hydrocortisone (blood)
• Male
• Middle Aged
• Operative Time
• Pneumoperitoneum, Artificial (adverse effects, methods)
• Pressure
• Prospective Studies
• Stress, Physiological (physiology)
• Young Adult