The Role of Minimum Fluid Requirement Post Laparoscopic Cholecystectomy in Comparison to Open Cholecystectomy Al-Shammari AJ1, Al-Zubaidi SA1, Al-Zubaidi SA1,* 1College of Medicine, Al-Qadissiya University, Iraq *Corresponding Author: Al-Zubaidi SA, College of Medicine, Al-Qadissiya University, Iraq, Email: madridionajh@gmail.com
Online published on 23 December, 2019. Abstract Background The post-operative management of a patient's fluid balance is one of the most critical aspects of hospital care. Nowadays, many opinions exist as to the best volume of intravenous fluid after elective surgery, as recent studies suggested that a reduction in fluid need after operation to lowest need to reduce complication and postoperative hospital stay. The aim of current study was to evaluate fluid requirement and maintenance in patients after elective laparoscopic cholecystectomy in comparison with elective open cholecystectomy. Method A prospective study involving cholecystectomized patients at Al-Diwaniyah Teaching Hospital for the period from February 2018 to February 2019. Age, sex, body mass index, bowel sound parameters used and selection with aid of American society of anesthesiologists classification also used. Post-operative fluid regime of formula with 10ml/kg of glucose saline was used for the first 8 post-operative hours, with follow up chart. Onset of oral intake and discharge from hospital were discussed and evaluated. Results Our study included 140 patients who underwent cholecystectomy; 90 patients with laparoscopic cholecystectomy and 50 patients with open cholecystectomy. The patient's median age was 40 years. There were ninety two females (66%) and forty eight male (34%) patients. In patients with laparoscopic cholecystectomy; 78 patients (87%) needed no further fluid support, resumed oral intake and discharged home within 10–14 hours after operation, whereas 34 patients (68%) of open cholecystectomy were continued on intravenous fluid support. Discharge of all patients with open cholecystectomy was after 24 hours. Statistically, there was highly significant timing change in starting oral feeding in laparoscopic cholecystectomy and timing to start oral intake in comparison with open cholecystectomy, and showed highly significant relation between age of patient and timing needed to start oral intake postoperatively. On the other hand, there was no significant relation between age and time needed to start oral intake postoperatively in open cholecystectomy. Conclusions Restrict post-operative intravenous fluid for maintenance therapy in elective and uncomplicated laparoscopic cholecystectomy in fit patients in the aim of early discharge of patients from hospital as a day case surgery. Top Keywords Laparoscopy, cholecystectomy, intravenous fluid, oral intake, postoperative. Top |