Objective: To investigate the impairment of pulmonary function and complications after laparoscopic compared with open cholecystectomy through an upper midline incision.
Design: Prospective randomised trial.
Setting: Teaching hospital, Spain.
Subjects: 40 patients, 20 in each group.
Interventions: Clinical examination, spirometry, arterial blood gas analysis, and chest radiographs before and after operation.
Results: 48 hours postoperatively FVC and FEV1 had decreased to 56.7% and 53%, respectively, in the patients who had had open cholecystectomy, compared with 85.3% and 84.8% in the laparoscopic group (p < 0.0001). The mean (SD) postoperative percentage reductions in both PaO2 (86.1 (11.1) compared with 98.3 (11.3)) and SatO2 (98.6 (1.3) compared with 100 (1.5)) were also greater in the open group (p < 0.005 in both cases).
Conclusions: Laparoscopic cholecystectomy causes less impairment of lung function than cholecystectomy through an upper midline incision.