Pir Muneeb Rehman, Farhan Ahmad, Saad Bin Anis.
Comparison of Low Pressure versus high Pressure Laparoscopic Cholecystectomy; a Randomized Controlled Trial.
Pak J Med Health Sci Jan ;12(4):1516-8.

Aim: To compare the frequency of doubling in liver enzymes with low pressure (LP) vers us high pressure (HP) laparoscopic cholecystectomy (LC). Methodology: A total number of sixty (60) patients planned for elective cholecystectomy having age 20-70 years, of any gender, having normal ALT, AST levels before cholecystectomy were included in this randomized clinical trial within a duration of six months from Jan-2017 to June-2017. In group LP-LC, low pressure CO 2 (7mmHg) was used to create pneumo-peritoneum. In group HP-LC, high pressure CO 2 (14mmHg) was used to create pneumo- peritoneum. Veress needle was used for creation of pneumo-peritoneum. Liver enzymes such as ALT and AST were measured after 48 hours of cholecystectomy. Results: Mean age of patients was 43.35+/-9.75 years in LP-LC group and 42.36 +/- 10.58 years in HP-LC group (p-value 0.70). Female population was predominant, 23(76.7%) were male patients in LP-LC group and 24 (80%) in HP-LC group (p-value 0.75). Mean operation time was 89.47+/-17.14 minutes in H P-LC group and 93.41+/-19.79 minutes in LP-LC groups (p-value 0.41). In post-operative period, doubling of liver enzymes was found in 2 (6.67%) patients, and in 10(33.3%) patients in HP-LC group (p-value 0.009). Conclusion: Low pressure laparoscopic cholecystectomy (LP-LC) is more safe as compared to the high pressure laparoscopic cholecystectomy (HP-LC) and is associated with less increase in liver enzymes in post- operative period.

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