M.b. Jahantab, A. Mohsenpour, Sh. Salaminia, S. Mehrabi Sisakht, N. Roustaei, J.m. Malekzadeh, M.j. Yavari Barhaghtalab,
Volume 5, Issue 4 (Fall 2024)
Abstract
Aims: Intraperitoneal CO2 insufflation appears to be a risk factor for alterations in coagulation and liver function tests (LFT) following laparoscopic cholecystectomy. Therefore, the present study was conducted with the aim of comparing the effect of low-pressure CO2 intraperitoneal insufflation (12-15 mmHg), and high-pressure CO2 intraperitoneal insufflation (16-20 mmHg) on the patient's coagulation status and liver function test after laparoscopic cholecystectomy.
Materials & Methods: This randomized clinical trial consisted of 150 patients who were candidates for laparoscopic cholecystectomy and referred to Shahid Beheshti and Shahid Jalil Hospitals affiliated with Yasuj University of Medical Sciences, Iran in 2022-2023. They were selected using the convenience sampling method and allocated to two different CO2 insufflation pressure levels, either 12-15 or 16-20 mmHg by random sampling method (75 patients each). Coagulation profile including prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), bleeding time (BT), and liver function tests such as AST (Aspartate Aminotransferase), ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), total bilirubin (T.bili), and direct bilirubin (D.bili) were measured and recorded in the night before the operation and 24 hours after the operation. The data was analyzed by SPSS 16 (p-value<0.05).
Findings: There was a significant increase in PT (p=0.035), and a decrease in BT (p=0.0001) in the group with pressure levels of 16-20 compared to 12-15 mmHg after the intervention.
Conclusion: The level of intraperitoneal CO2 insufflation has no effect on coagulation and liver. Therefore, CO2 pressure of 12-20 can be used safely in laparoscopic cholecystectomy surgeries.
