The impact of standard and low-pressure pneumoperitoneum on hydration in obese females undergoing laparoscopic cholecystectomy

Introduction
Disturbances in hydration status can increase the frequency of post-operative pain, nausea and vomiting (PONV), complicate the wound healing process and thus, increase the period of hospitalization, especially in overweight and obese patients.

Aim of the research
To assess the impact of the standard and low-pressure pneumoperitoneum on hydration status of obese female patients undergoing laparoscopic cholecystectomy in the early post-operative period.

Material and methods
The study included 52 female individuals with asymptomatic cholelithiasis who underwent laparoscopic cholecystectomy. Patients were assigned to three groups according to the body mass index and value of intra-abdominal pressure. Evaluation of the hydration status was performed at three time points: point 0 – before the operation, point 24 – 24 hour after the surgery, and point 48 – 48 hours after the surgery.

Results
A higher total body water (TBW) and dehydration was observed in obese compared to normal weight patients in the time point 24 and 48. Extracellular water (ECW) was significantly higher in obese compared to normal weight patients in the time studied time point. Intracellular water (ICW) and ECW/ICW did not differ significantly between the studied groups in the studied time.

Conclusions
Obesity alters the hydration status. Values of carbon-dioxide pneumoperitoneum pressure used during short duration laparoscopic surgery did not have an influence on the hydration status of the obese female patients.