ASSOCIATION OF RIGHT SHOULDER TIP PAIN AND GLISSON’S CAPSULE INJURY FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL CROSS-SECTIONAL STUDY. ijan111333000999@gmail.com

 

ASSOCIATION OF RIGHT SHOULDER TIP PAIN AND GLISSON’S CAPSULE INJURY FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL CROSS-SECTIONAL STUDY.

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India

Poster with Discussion

The incidence of shoulder tip pain (STP) after laparoscopic cholecystectomy (LC) varies from 30 to 50%. STP following LC may occur on the right, left, or both sides. The liver and Glisson’s capsule (GC) are innervated by the sensory part of the phrenic nerve, which, when irritated, causes referred pain to right shoulder, known as right STP (RSTP). The aim of the study was to identify whether the Glisson’s capsule (GC) injury during LC responsible for postoperative right shoulder tip pain (RSTP).

This observational cross-sectional study was conducted over 18 months. We enrolled patients aged ≥18 years who underwent LC. Demographic data, preoperative investigations, and intraoperative video recordings were used to evaluate GC injury (Figure 1). Postoperative shoulder tip pain was noted separately at 6,12,24 and 48 hours. The intraoperative video recordings of GC injury was evaluated by indipendent surgeon and confirmed by the evaluator. This was then compared with patients who experienced postoperative RSTP after LC. Data were recorded in a Microsoft Excel spreadsheet.

The study included 215 patients with a mean age of 42.65 years. Forty-one participants (19.1%) were male, and 174 (80.9%) were female. Our study showed that the incidence of RSTP after LC was 41.9%. Of 90 patients who had RSTP, 81 (90%) had GC injury, which was a significant finding (p = 0.017) (Table 1).

Our study demonstrated an association between GC injury and post-LC RSTP. Therefore, sufficient intraoperative precautions should be taken to avoid GC injury during LC.