Standard Pressure Vs Low Pressure Laparoscopic Cholecystectomy: Comparative Insights into a Tertiary Healthcare Setting in Lahore

Background: Laparoscopic cholecystectomy (LC) had been taken as the standard of care in the treatment of the gallbladder disease. Another alternative that could be put in place of countering the undesirable side effects associated with the LC was the low-pressure laparoscopic cholecystectomy (LPLC). This study was done to compare the performance of SPLC and LPLC based on the postoperative pain, operating time and occurrence of shoulder tip pain. Methods: A total of one hundred and eighty patients undergoing elective LC were randomised into SPLC group (n=90) or the LPLC group (n=90). Sampling was done using the Open Epi 3.0.0 with CI of 95 and power of 80. The postoperative pain was measured using visual analogue scale (VAS) at 6, 12, 18 and 24 hours of operation. The pain at the tip of the shoulder and length of surgery were recorded as well. All statistical procedures have been performed in SPSS 25.0. Results: The mean operative time was similar in both the SPLC and LPLC groups (35.40 ± 8.94 minutes vs. 37.40 ± 7.89 minutes, p=0.1125). Postoperative pain scores were lower in the LPLC group at all measured time points (p=0.0001). The frequency of shoulder tip pain was notably reduced in the LPLC group 6 (6.67%) compared to the SPLC group 23 (25.56%). SPSS version 26.0 was used with p-value<0.05. Conclusion: LPLC offered significant advantages over SPLC by reducing the postoperative pain as well as the incidence of shoulder tip pain without altering the operative time.