Pulmonary function after cholecystectomy performed through Kocher's incision, a mini‐incision, and laparoscopy

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Abstract
Comparative pulmonary function after cholecystectomy performed through Kocher's incision, a mini‐incision, and laparoscopy was evaluated. Forty‐five patients were randomly and prospectively divided into three groups of 15 each, depending on the surgical access employed. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), and forced expiratory flow at 25% to 75% (FEF25–75%) were determined 1 to 3 days before and 16 to 24 hours after cholecystectomy. The percent reduction of FVC (p=0.0170), FEV1(p=0.0191), and FEF25–75%(p=0.0045) was smaller after laparoscopic cholecystectomy than after Kocher's incision cholecystectomy. The percent reduction of FVC (p=0.0170) was smaller after mini‐incision cholecystectomy than after Kocher's incision cholecystectomy. There was no difference in the FEV1(p=0.0971) or FEF25–75%(p=0.2058) between these two groups. FEF25–75%was significantly less impaired in the laparoscopic group than in the mini‐incision group (p=0.0327). No difference between these two groups was found in FVC (p=0.5755) or FEV1(p=0.3952). It is concluded that postoperative pulmonary function is less impaired after laparoscopic cholecystectomy than after either mini‐incision or Kocher's incision cholecystectomy.

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