Comparative Changes in Tissue Oxygenation Between Laparoscopic and Open Cholecystectomy

BACKGROUND: Previous studies examined the effect of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) on physiological variables of the respiratory system. In this study we compared changes in arterial blood gases-related parameters between LC and OC to assess their comparative influence on gas exchange. METHODS: We studied 28 patients, operated under identical anesthetic protocol (LC: 18 patients, OC: 10 patients). Measurements were made on the morning before surgery (BS), the second (AS2) and the eighth (AS8) postoperative day. Studied parameters, including alveolar-arterial difference in PO(2) ((A-a)DO(2)) and oxygen content (Oct in vol%), were statistically compared. RESULTS: On AS2 a greater increase was found in ((A-a)DO(2)) for the OC compared to LC (4.673 ± 0.966 kPa versus 3.773 ± 1.357 kPa, respectively). Between BS and AS2, Oct in vol% decreased from 17.55 ± 1.90 to 15.69 ± 1.88 in the LC and from 16.99 ± 2.37 to 14.62 ± 2.23 in the OC, whilst a reduction (P = 0.093) between AS2 and AS8 was also found for the open method. Besides, on AS2, SaO(2)% decrease was greater in OC compared to LC (P = 0.096). CONCLUSIONS: On AS2, the greater increase in OC-((A-a)DO(2)) associated with Oct in vol% and SaO(2)% findings also in OC group suggest that LC might be associated with lower risk for impaired tissue oxygenation.