Open Versus Closed Pneurnoperitoneum in Laparoscopic Cholecystectomy

Abstract

Objective: To present experience of open versus closed pneumoperitoneum in laparoscopic cholecystectomy. Design: This is an observational, comparative study. Place and duration: South Surgical Unit, Mayo Hospital, Lahore, from Jan 2001 to Dec 2002. Subjects and methods. This observational, comparative study was conducted in South Surgical Unit, Mayo Hospital, Lahore. Hundred patients under-going laparoscopic cholecystectomy using conventional pneumoperitoneum techniques from January 2001 to December 2002 were included in this study. The closed and open techniques of establishing pneumoperitoneum have been compared for the time required for each technique, complications and post-op hospital stay. Results: In this study 72 patients out of 100 underwent closed establishment of pneumoperitoneum and in 28 patients open technique was employed. Time required to establish pneumoperitoneum was one to two minutes with a mean of 1.18 minutes in closed technique. It was two to three minutes with a mean of 2.21 minutes in open technique. Paired-t test was applied and value of t was -1.721, df 98 and p-value 0.000. So the difference was significant. Time required to close the wound was one to three minutes with a mean of 2.24 in closed and two to five minutes with a mean of 3.32 in open technique. T-value was -8.752, df 97 and p-value 0.000. So the difference was significant. Post-op day of discharge was one to five in closed and one to seven in open technique. t-value was -1 .390,df 98 and p-value 0.168. So the difference was not significant. Complications in 13 out of 72 patients occurred in closed while 6 patients out of 28 developed complications with open technique. Chi square test was applied p-value was found 0.994 8 in open pneumoperitoneum. This shows that the difference is not significant. Conclusions: It is concluded from this study that the closed technique is better than open technique as regards the time required to establish the pneumoperitoneum and to close the wound. As there is no significant difference for complications and post-op hospital stay, so the closed technique can be used safely as well.