SynthesisSurgical endoscopy2020
The impact of intra-abdominal pressure on perioperative outcomes in laparoscopic cholecystectomy: a systematic review and network meta-analysis of randomized controlled trials.
Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 42 citations in OpenAlex.
- Trial
- Trial
- Ultrasound-guided quadratus lumborum block provided more effective analgesia for children undergoing lower abdominal laparoscopic surgery: a randomized clinical trial.Surgical endoscopy · 2022Trial
- Trial
- Hepatosplanchnic perfusion changes following isolated abdominal trauma and surgery: A scoping review of evidence dominated by pneumoperitoneum models.Physiological reports · 2026Article
- Article
- Variations of SPI during outpatient laparoscopic cholecystectomy without muscle relaxants using ANI-guided remifentanil.Journal of clinical monitoring and computing · 2025Observational
- Article
- The abdominal compliance index and postoperative pain after laparoscopic gynecologic surgery: a preliminary observational cohort study.Turkish journal of medical sciences · 2025Observational
- The Impact of Intra-abdominal Pressure on Perioperative Outcomes in Laparoscopic Cholecystectomy.Cureus · 2024Article
- Underneath Images and Robots, Looking Deeper into the Pneumoperitoneum: A Narrative Review.Journal of clinical medicine · 2024Review
- Best Evidence for Each Surgical Step in Minimally Invasive Right Hemicolectomy: A Systematic Review.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Review
- Abdominal compartment syndrome in critically ill patients.Acute and critical care · 2023Article
- Robotic single-site cholecystectomy is better in reducing postoperative pain than single-incision and conventional multiport laparoscopic cholecystectomy.Surgical endoscopy · 2023Article
- Low Intra-Abdominal Pressure with Complete Neuromuscular Blockage Reduces Post-Operative Complications in Major Laparoscopic Urologic Surgery: A before-after Study.Journal of clinical medicine · 2022Article
- The Impact of intra-abdominal Pressure on Perioperative Outcomes in Robotic-Assisted Radical Prostatectomy: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.Journal of oncology · 2022Review
- Can We Routinely Employ the Use of Low-Pressure Gynaecological Laparoscopy? A Systematic Review.Cureus · 2021Review
- The "Dark Side" of Pneumoperitoneum and Laparoscopy.Minimally invasive surgery · 2021Review
- Low-Pressure Versus Normal-Pressure Laparoscopic Cholecystectomy and its Effect on Intra-Operative Parameters and Post-Operative Pain: An Observational Study.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic cholecystectomy involves using intra-abdominal pressure (IAP) to facilitate adequate surgical conditions. However, there is no consensus on optimal IAP levels to improve surgical outcomes. Therefore, we conducted a systematic literature review (SLR) to examine outcomes of low, standard, and high IAP among adults undergoing laparoscopic cholecystectomy.
methodsAn electronic database search was performed to identify randomized controlled trials (RCTs) that compared outcomes of low, standard, and high IAP among adults undergoing laparoscopic cholecystectomy. A Bayesian network meta-analysis (NMA) was used to conduct pairwise meta-analyses and indirect treatment comparisons of the levels of IAP assessed across trials.
resultsThe SLR and NMA included 22 studies. Compared with standard IAP, on a scale of 0 (no pain at all) to 10 (worst imaginable pain), low IAP was associated with significantly lower overall pain scores at 24 h (mean difference [MD]: - 0.70; 95% credible interval [CrI]: - 1.26, - 0.13) and reduced risk of shoulder pain 24 h (odds ratio [OR] 0.24; 95% CrI 0.12, 0.48) and 72 h post-surgery (OR 0.22; 95% CrI 0.07, 0.65). Hospital stay was shorter with low IAP (MD: - 0.14 days; 95% CrI - 0.30, - 0.01). High IAP was not associated with a significant difference for these outcomes when compared with standard or low IAP. No significant differences were found between the IAP levels regarding need for conversion to open surgery; post-operative acute bleeding, pain at 72 h, nausea, and vomiting; and duration of surgery.
conclusionsOur study of published trials indicates that using low, as opposed to standard, IAP during laparoscopic cholecystectomy may reduce patients' post-operative pain, including shoulder pain, and length of hospital stay. Heterogeneity in the pooled estimates and high risk of bias of the included trials suggest the need for high-quality, adequately powered RCTs to confirm these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.