European Journal of Molecular & Clinical Medicine

Abstract

Background: In the present era, laparoscopic cholecystectomy is considered as gold standard for symptomatic gallstone disease. This study aimed to assess the feasibility of Low-pressure capanoperitoneum laparoscopic cholecystectomy (i.e. at 7 mmHg) in patients with the comorbid condition and compared the result with normal patients without any comorbidity.
Material and method: This prospective, single-centre comparative study was conducted in Department of Surgery, in Baba Raghav Das Medical College, Gorakhpur, for a period of 1 year from 2nd April 2019 to 1st April 2020, on symptomatic gall stone patients who were admitted with or without comorbid conditions and were planned for cholecystectomy. A total of 72 patients were included in the study and after detailed investigation, the patients were divided into two groups based on whether they have any comorbid conditions or not. Low-pressure capnbperitoneum laparoscopic cholecystectomy was performed in 37 patients with the comorbid condition and they are referred to as a study group. The control group includes 35 patients without any comorbidity. Different intraoperative and postoperative parameters were studied in both groups. 
Results: In patients     with co-morbid conditions mean blood loss (p value=0.0001) and mean operative time (p value=0.0006) was significantly higher compared to the control group. Conversion rate(p value=0.42), intra-operative complication rate(p value>0.05) , postoperative pain score(p value>0.05), postoperative complication, postoperative nausea and vomiting(p value>0.05), mean time to resume diet(p value=0.05) quality of life on day 5 (physical domain) and postoperative hospital (p value=0.09), were not different in patient with comorbid condition as compared to patient without comorbid condition. Low-pressure capnoperitoneum laparoscopic cholecystectomy is a safe treatment for cholecystitis in elderly, in obese or in diabetic patients. However elderly and obese patients are at greater risk for conversion, slightly more blood loss, and increased operative time. In diabetic patients incidence of postoperative complication is more compared to the control group.
Conclusion: This study concluded that Low-pressure capanoperitoneum laparoscopic cholecystectomy is a safe procedure for patients with comorbid conditions.