The relationship between early postoperative pain and intraperitoneal residual gas after laparoscopic cholecystectomy

Özet

Introduction: This study was designed to investigate the relationship between laparoscopic cholecystectomy (LC) patients’ abdominal residual gas volume and abdominal pain in the early postoperative period,and to investigate the effect of draining the residual gas in different ways on abdominal and shoulder pain.Materials and Methods: The study included 63 patients who were undergoing an elective LC. The patientswere divided into 3 groups of equal number: a simple LC group, in which carbon dioxide was drained from theabdomen without any further treatment; an LC with aspiration group; and an LC group with a drain placedin the gallbladder bed after the procedure. Posteroanterior chest radiography was performed on all of thepatients at the sixth postoperative hour to determine the amount of residual gas under the diaphragm. Postoperative shoulder and abdominal pain were evaluated using the visual analogue scale (VAS).Results: There were no significant differences related to age, weight, sex, or surgical duration. There wasa statistically significant difference at the first postoperative hour between the group that had only an LCand the LC with aspiration group when the VAS shoulder and abdominal pain scores of the 3 groups werecompared. When the gas volume at the sixth hour was compared, the LC with aspiration group was found todemonstrate a significantly smaller volume than the other 2 groups (p<0.05).Conclusion: Fully aspirating the gas in the abdomen after LC will increase patient comfort by reducing backand shoulder pain commonly observed in the early postoperative period.