Normal inspiratory muscle strength is restored more rapidly after laparoscopic cholecystectomy

M. L. Da Costa, M. A. Qureshi, N. M. Brindley, P. E. Burke, P. A. Grace, D. Bouchier-Hayes

Research output: Contribution to journalArticlepeer-review

Abstract

Respiratory complications after laparotomy cholecystectomy may result from generalised muscle weakness and fatigue, or from reduced respiratory muscle function secondary to an upper abdominal incision. In a prospective study we compared maximal inspiratory effort (Pi(max)/mmHg) and dominant hand grip strength (kPa) (expressed as a percentage of zero hour value) in patients undergoing open cholecystectomy (OC) (n=12), laparoscopic cholecystectomy (LC) (n=25) and a control group of patients undergoing lower limb surgery (n=12). Of the 12 OC patients, three suffered respiratory complications: two had atelectasis and one a chest infection, compared with no such complications in the other two groups (P<0.05). Pi(max) decreased postoperatively in all groups (P<0.05) and had returned to normal by 48 h in the LC and control groups. In contrast, in the OC group Pi(max) fell from 112.5 ± 17.8 mmHg to as low as 81.3 ± 16.5 mmHg at 72 h and only returned to preoperative levels at 120 h. The hand grip strength fell significantly in all groups at 24 h (P<0.05) but normal levels were achieved again by 48 h in all groups, and there was no significant difference in the hand grip strength between the groups over the 5 days. These results suggest that generalised muscle fatigue after surgery is similar after open and laparoscopic cholecystectomy. Open cholecystectomy does, however, cause a more prolonged reduction in respiratory muscle function and this is likely to contribute to the higher incidence of respiratory complications in this group of patients.

Original languageEnglish
Pages (from-to)252-255
Number of pages4
JournalAnnals of the Royal College of Surgeons of England
Volume77
Issue number4
Publication statusPublished - 1995
Externally publishedYes

Keywords

  • Laparoscopic cholecystectomy
  • Respiratory muscles

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