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Upper abdominal surgery is associated with characteristic changes in pulmonary function which increase the risk of lower lobe atelectasis. Sixteen patients undergoing open cholecystectomy and 20 patients undergoing laparoscopie cholecystectomy were prospectively evaluated by pulmonary function tests (forced vital capacity FVC, forced expiratory volume FEV-1, and forced expiratory flow FEF 25% to 75%) before operation and on the morning after surgery to determine if the laparoscopie technique lessens the pulmonary risk. Fraction of the baseline pulmonary function was calculated by dividing the postoperative pulmonary function by the preoperative pulmonary function and multiplying by 100%. Postoperative FVC measured 52% of preoperative function for open cholecystectomy and 73% for laparoscopie cholecystectomy (p = 0.002). Postoperative FEV-1 measured 53% of baseline function for open cholecystectomy and 72% for laparoscopie cholecystectomy (p = 0.006). Postoperative FEF 25% to 75% measured 53% for open cholecystectomy and 81% for laparoscopie cholecystectomy (p = 0.07). It is concluded that laparoscopie cholecystectomy offers improved pulmonary function compared to the open technique.
Frazee et al. (Sat,) studied this question.