Effectiveness of Peritoneal Lavage in Reducing Postoperative Pain in Elective Laparoscopic Cholecystectomy: A Prospective Cohort Study.

INTRODUCTION

Postoperative pain in laparoscopic cholecystectomy is not well studied. Peritoneal lavage is performed in cases of acute or complicated cholecystitis, whereas it is uncommon in cases considered clean surgeries; paradoxically, this latter group reports more pain.

OBJECTIVE

To evaluate the association between peritoneal lavage and postoperative pain levels in patients undergoing laparoscopic cholecystectomy.

METHODS

Prospective cohort study on 110 patients with gallbladder pathology scheduled for elective laparoscopic cholecystectomy. Groups: with peritoneal lavage (n1 = 55) and without peritoneal lavage (n2 = 55). Pain was evaluated at 6, 12, and 24 h using the visual analog scale (VAS). Numeric variables were described as means or medians. Categorical variables were described as absolute frequencies and percentages. The association between peritoneal lavage and postoperative pain levels was analyzed using Linear Quantile Mixed Models (LQMMs) with the 'lqmm' package in R.

RESULTS

Pain assessment shows that the median pain scale scores were significantly lower at 6, 12, and 24 postoperative hours (p < 0.001) in patients who received peritoneal lavage. The adjusted median differences ranged from -1.6 to -1.7 points on the VAS across all evaluated time points, indicating consistently lower postoperative pain scores in the lavage group.

CONCLUSIONS

Peritoneal lavage with saline solution during laparoscopic cholecystectomy was associated with lower postoperative pain scores during the first 24 postoperative hours.