Dynamic respiratory patterns after laparoscopic cholecystectomy.

Abstract

Important alterations in respiratory function have been observed after open cholecystectomy. These include a decrease in the abdominal tidal volume, forced vital capacity, and forced expiratory volume at 1 s. Laparoscopic cholecystectomy is a new procedure allowing removal of the gallbladder without a subcostal or midline incision. The result is less postoperative pain and earlier ambulation. This study sought to determine whether changes in rib cage and abdominal wall motion are different after laparoscopic than open cholecystectomy. Twelve otherwise healthy patients underwent respiratory inductive plethysmography prior to and one day after laparoscopic cholecystectomy. Frequency of resting breathing increased 29 percent after laparoscopic cholecystectomy (p = 0.03), while abdominal motion decreased 32 percent (p = 0.03). During coached abdominal breathing, rib cage tidal volume increased 70 percent (p = 0.005) and abdominal tidal volume decreased 29 percent (p = 0.01). These alterations in respiratory pattern after laparoscopic cholecystectomy were smaller in magnitude than those reported following the open procedure.