The comparison of pulmonary functions in open versus laparoscopic cholecystectomy.

OBJECTIVE To examine respiratory functions of patients after open and laparoscopic cholecystectomy and to compare the advantages. METHODS Fifty five cases with cholelithiasis subjected to elective cholescystectomy were studied. The patients were divided into two groups. Open Cholecystectomy (OC) was performed on 27 cases (Group I), and Laparoscopic Cholecystectomy (LC) in 28 cases (Group II). Respiratory function tests were performed 24 hours before the operation and on the 1st and 6th day after surgery. Blood gas values and anaesthesia periods were recorded. Forced expiratuary volume in the 1st second (FEV1), forced vital capacity (FVC) and FEV1/FVC values were also noted. RESULTS FEV1, FVC and FEV1/FVC values on first post-operative day in all cases were statistically lower than the preoperative values (p = 0.0001). Percentage changes of respiratory function test was calculated preoperatively and 1st postoperative day. The changes in both groups showed a significant decrease in FEV1, FVC and FEVI/FVC in Group I compared to Group II (p = 0.0001 in FEV1, p = 0.007 in FVC and p = 0.004 in FEV1/FVC). There was no significant difference in respiratory function tests evaluated on the 6th postoperative day and they had returned to normal values. There was no difference among preoperative and postoperative PaCO2, pH values in arteriel blood gas values in all cases (p = 0.355 p = 0,215). These parameters did not differ in both groups (p = 0.527, p = 0.591), There was a significant decrease in PaO2 and O2 saturation in all cases (p = 0.0001), but there was no significant difference when both groups were compared (p = 0.166, p = 0.678). CONCLUSION The better results of pulmonary function tests in patients subjected to LC proves the advantage of the procedure over OC.