Efficacy of low-pressure versus high-pressure pneumoperitoneum in restoration of bowel sounds after laparoscopic cholecystectomy.

Abstract

Objective: To compare the effectiveness of low-pressure versus high-pressure pneumoperitoneum in facilitating the return of bowel sounds within six hours following laparoscopic cholecystectomy. Study Design: Randomized Controlled trial. Setting: Department of Surgery, Allied Hospital, Faisalabad. Period: November’2020 to April’2021. Methods: Sixty patients aged 25–70 undergoing elective laparoscopic cholecystectomy were randomly assigned to two groups: Group A (low-pressure CO₂, <10 mmHg) and Group B (high-pressure CO₂, 14 mmHg). Patients with complicated gallbladder disease or comorbidities like CRF and CLD were excluded. Results: The mean ages in Groups A and B were 43.17 ± 11.20 and 45.20 ± 10.76 years, respectively. The majority (83.33%) of participants were female. Return of bowel sounds within six hours postoperatively occurred in 30% of Group A patients versus 3.33% in Group B (p = 0.006), indicating a statistically significant difference favoring low-pressure pneumoperitoneum. Conclusion: Low-pressure pneumoperitoneum significantly enhances early return of bowel function after laparoscopic cholecystectomy compared to high-pressure pneumoperitoneum.