Jie Hua1, Jian Gong2, Le Yao2, Bo Zhou2, Zhenshun Song3. 1. Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China; Department of General Surgery, First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China. 2. Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China. 3. Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China. Electronic address: zs_song@hotmail.com.
Abstract
BACKGROUND: The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear. METHODS: A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed. RESULTS: A total of 1,263 patients were included. Low-pressure pneumoperitoneum was associated with significantly decreased postoperative pain. The requirement for increased pressure was significantly greater in the low-pressure group (risk ratio = 6.16; P < .001). Operative time was similar, with only a slight statistical significance (weighted mean difference = 2.07; P < .001). Length of hospital stay was shorter in the low-pressure group (weighted mean difference = -.27; P = .01). No significant differences were found in surgical complications or conversion to open surgery. CONCLUSIONS: Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative pain and near-equal operative time compared with standard-pressure pneumoperitoneum. More studies are required to investigate the potential benefits of the reduced length of hospital stay. Crown
BACKGROUND: The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear. METHODS: A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed. RESULTS: A total of 1,263 patients were included. Low-pressure pneumoperitoneum was associated with significantly decreased postoperative pain. The requirement for increased pressure was significantly greater in the low-pressure group (risk ratio = 6.16; P < .001). Operative time was similar, with only a slight statistical significance (weighted mean difference = 2.07; P < .001). Length of hospital stay was shorter in the low-pressure group (weighted mean difference = -.27; P = .01). No significant differences were found in surgical complications or conversion to open surgery. CONCLUSIONS: Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative pain and near-equal operative time compared with standard-pressure pneumoperitoneum. More studies are required to investigate the potential benefits of the reduced length of hospital stay. Crown