Abstract: Objective The aim of this study was to investigate the impact of different pneumoperitoneum pressures (PPP) on respiratory and hepato-renal functions in patients with cholecystolithiasis and chronic cholecystitis receiving laparoscopic cholecystectomy (LC). Methods 94 patients with cholecystolithiasis and chronic cholecystitis were enrolled in our hospital between April 2021 and April 2025, and all received LC surgery. During the operation, the patients were randomly divided into two groups, receiving low PPP (8-12 mmHg) in 47 cases and high PPP (13-16 mmHg) in another 47 cases. The peak expiratory flow (PEF), forced vital capacity (FVC) and mid-expiratory flow (FEF_25%-75%) were measured by standardized forced expiratory test. Pain was evaluated by VAS. Results One day after operation, the PEF, FVC and FEF_25%~75% in low PPP group were (62.9±12.9) L, (71.4±13.5)L and (87.1±20.1)L/sec, all much higher than [(41.0±10.2)L, (46.8±11.5)L and (44.8±10.4)L/sec, respectively, P<0.05] in high PPP group; by end of three days after surgery, serum ALT and AST levels in low PPP group were (47.3±11.4)IU/L and (42.9±12.1)IU/L, both much lower than [(75.1±12.6)IU/L and (64.9±14.2)IU/L, respectively, P<0.05] in high PPP group; serum BUN and Cr levels were (4.9±1.0)mmol/L and (90.1±10.3)μmol/L, both significantly lower than [(5.5±1.1)mmol/L and (97.1±11.2)μmol/L, respectively P<0.05] in high PPP group; postoperative bowel sound recovery, anal exhaust and first defecation time in low PPP group were(13.5±2.3) h, (18.9±4.9) h and (27.4±7.4) h, all much shorter than [(18.7±3.6)h, (25.8±5.3)h and (42.1±8.5)h, respectively, P<0.05] in high PPP group; the incidence rate of postoperative shoulder pain in low PPP group was 19.2%, much lower than 45.2%(P<0.05) in high PPP group. Conclusion We recommend relative low pneumoperitoneum pressure at 8-12 mmHg during LC operation in patients with cholecystolithiasis and chronic cholecystitis, which might influence less respiratory and hepato-renal functions.

Key words: Cholecystolithiasis, Chronic cholecystitis, Laparoscopic cholecystectomy, Pneumoperitoneum pressure, Therapy