Author(s): Millitz K, Moote DJ, Sparrow RK, Girotti MJ, Holliday RL
OBJECTIVE: This study aimed to determine the frequency and duration of pneumoperitoneum after laparoscopic cholecystectomy, as detected on upright chest radiographs.
MATERIALS AND METHODS: Fifty-five patients who underwent laparoscopic cholecystectomy were studied prospectively. Upright posteroanterior chest radiographs were obtained 6 hr after surgery (day 1); additional radiographs were obtained on days 2, 4, 7, and 14, if required, until the pneumoperitoneum resolved. A perpendicular measurement of any pneumoperitoneum detected between the diaphragm and the liver was obtained. The pneumoperitoneum was graded as absent, trace (1-5 mm), mild (6-10 mm), or moderate (10-15 mm).
RESULTS: No evidence of pneumoperitoneum was seen on chest radiographs taken 6 hr after surgery (day 1) in 27 (54\%) of the 50 patients who completed the study. Of the remaining 23 patients (46\%), all but one showed resolution of the pneumoperitoneum in the first week. Of these 23 patients, 17 showed trace pneumoperitoneum and six showed mild pneumoperitoneum on chest radiographs.
CONCLUSION: Despite the use of carbon dioxide gas during laparoscopic cholecystectomy, a significant number of patients have postsurgery pneumoperitoneum that is visible on upright chest radiographs. The pneumoperitoneum resolves in most patients within the first week after surgery.Medical & Surgical Urology