Significance of Post-Operative Free Gas in Laparoscopic Surgery
Brijesh Parekh*, Ronak R. Modi*, Asit V. Patel***.
Abstract Laparoscopic surgery is routinely performed nowadays at all centers with better patient outcome. But, in post-operative period, if any hollow viscus perforation occurred; either due to underlying pathology, or may be due to iatrogenic injury during laparoscopic surgery, can be missed in early stage due to pneumo-peritoneum created during laparoscopic surgery. We document our study on 50 patients to see patient outcome and time duration of resolution of pneumoperitoneum. Weíve done serial abdominal/chest x-rays in standing position from post-operative day 1 till the resolution of pneumo-peritoneum, in various laparoscopic procedures. On an average, CO2 used during total duration of surgery was 98.7 liter of CO2 in appendicectomy, 136.9 liter of CO2 in cholecystectomy & 140 liter of CO2 in hernioplasty. On observation, we didnít find pneumo-peritoneum on x-rays, even on post-operative day 1. In one patient, iatrogenic intra-operative cautery burn was present on anterior wall of stomach during laparoscopic cholecystectomy. But, on post-operative day-1, no pneumo-peritoneum was found. And even on serial abdominal/ chest x-rays on subsequent postoperative days also, we didnít find any free gas. That patient recovered better. On conclusion, serial study of abdominal/chest x-rays in standing position during post-operative period following laparoscopic surgery is a better tool, to diagnose any hollow viscera perforation at the earliest, or on the other hand, to rule out any suspected hollow viscus perforation. [Brijesh P NJIRM 2017; 8(4):35-37]
Key words: Laparoscopy, Pneumo-peritoneum, Free gas under diaphragm, Post-operative X-ray.
The List of Journals Indexed for MEDLINE publication ceased with the 2008 edition. The NLM Catalog can be used to obtain a list of currently indexed MEDLINE titles; select the Limit for Current Subsets called "Currently indexed in MEDLINE."
The List of Serials Indexed for Online Users online publication is designed to provide bibliographic information for serials from which articles are indexed with the MeSH® vocabulary and cited in MEDLINE®, the backbone of the NLM PubMed® database. More detailed bibliographic data and information about indexing coverage for serials cited in MEDLINE/PubMed can be found in LocatorPlus®, the NLM online catalog, and the NLM Catalog, an Entrez database.
Previous print versions of theList of Journals Indexed for MEDLINEmight be available from the U.S. Government Printing Office (GPO). Information about ordering documents from GPO is available athttp://www.nlm.nih.gov/pubs/pubcat.html#ordering.
The articles in National Journal of Integrated Research in Medicine are open access articles licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-sa/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.