Kunal Kailas Jadhav
Associate Professor, Department of Surgery, Rural Medical College and Hospital, Loni
Abstract
Laparoscopic cholecystectomy (LC) is a common procedure for treating gallbladder diseases, but post-operative shoulder tip pain (STP) remains a frequent issue, mainly caused by diaphragmatic irritation from carbon dioxide (CO₂) pneumoperitoneum. This study compares post-operative STP between low-pressure (10mmHg CO₂) and standard-pressure (14mmHg CO₂) pneumoperitoneum. A randomized trial of 200 patients was conducted, with pain assessed using a Visual Analogue Scale (VAS) at 6, 12, 24, and 48 hours postoperatively. The low-pressure group showed a statistically significant reduction in STP, without affecting surgical outcomes such as operative time or complications. This study suggests that low-pressure pneumoperitoneum can reduce post-operative STP and improve patient comfort following LC.
Keywords: Shoulder tip pain, low-pressure pneumoperitoneum, laparoscopic cholecystectomy, CO₂ insufflation, post-operative pain