Lung volumes 24 h 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.