ClinicalTrials.gg
CompletedNCT05530564Updated Sep 7, 2022

Effect of Low-pressure Pneumoperitoneum on Pain and Inflammation in Laparoscopic Cholecystectomy

An interventional study of low-pressure pneumoperitoneum and standard-pressure pneumoperitoneum in Pneumoperitoneum, Pain and Inflammatory Response, sponsored by University of Jordan. Completed at 1 site in Jordan. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2022-09-07.

Sponsored by University of Jordan · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 7 months after the study started (first participant enrolled Jan 2020, registered Aug 2022).
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
12 Years and older
Sex
All
01

Study summary

The purpose of this study is to assess the effect of low-pressure pneumoperitoneum on post operative pain and inflammation in patients undergoing elective laparoscopic cholecystectomy by comparing it to standard practice.

Read the detailed description

After obtaining informed consent from eligible study participants. patients were randomized into one of two masked groups, labelled red and green. The red-label group was operated at standard-pressure pneumoperitoneum, while the green-label group was operated at low-pressure pneumoperitoneum. Baseline blood samples were obtained pre-operatively for ten inflammatory markers, patients' demographics and intra-operative details collected, then post-operative pain and change in inflammatory markers were followed.

02

Conditions studied

  • Pneumoperitoneum
  • Pain
  • Inflammatory Response

Keywords

  • Clinical trial
  • low pressure insufflation
  • pneumoperitoneum
  • laparoscopic cholecystectomy
  • pain
  • inflammatory marker
03

In context

Pneumoperitoneum

153 studies on the registry are indexed under Pneumoperitoneum; 29 are open to participants now.

This study's enrollment of 100 is above the median of 80 across 98 interventional studies indexed under Pneumoperitoneum.

Browse Pneumoperitoneum studies →

Lead sponsor

University of Jordan is the lead sponsor of 130 studies on the registry; 20 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
12 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

- Elective admission for laparoscopic cholecystectomy

Exclusion criteria

Exclusion Criteria:

  • Current or previous diagnosis of acute cholecystitis confirmed by ultrasound
  • previous GI surgeries, except bariatric and anti-reflux surgeries
  • Currently on immunosuppressant agents
  • Pregnancy
  • Breastfeeding
  • Currently diagnosed with drug addiction
  • American Society of Anesthesiologists (ASA) score 3 and more
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
100 participants (actual)

Study arms

  • Experimental
    Low-pressure pneumoperitoneum

    Participants undergone laparoscopic cholecystectomy by creation of a low-pressure pneumoperitoneum, set at 8-10 mm Hg

    Procedure: low-pressure pneumoperitoneum

  • Active comparator
    Standard-pressure pneumoperitoneum

    Participants undergone laparoscopic cholecystectomy by creation of a standard-pressure pneumoperitoneum, set at 12-14 mm Hg

    Procedure: standard-pressure pneumoperitoneum

Interventions

  • Procedurelow-pressure pneumoperitoneum

    insufflation of the abdomen for creation of pneumoperitoneum, pressure set points between 8 to 10 mm Hg

  • Procedurestandard-pressure pneumoperitoneum

    insufflation of the abdomen for creation of pneumoperitoneum, pressure set points between 12 to 14 mm Hg

06

What researchers measure

Primary outcomes

  1. assessment of pain with SPS-11 at 6hr post-op

    measure difference in pain on the 11-point short pain scale (SPS-11) at 6-hour post-op compared to baseline at pre-op, minimum score of 0 , maximun score of 10 = pain at 6 hour post op - pain at pre-op

    Time frame: pre-op to 6 hours post op

  2. change in IL-6

    measure differance of inflammatory marker from baseline = baseline value- post op value (calculated in pg/mL) post-op collected at 24 hours from end of surgery

    Time frame: pre op to 24 hours post -op

Secondary outcomes

  1. assessment of difficulty of surgery

    to measure difference in surgery difficulty between the two groups using a scale of 1; easy, 2; moderate, 3; difficult. analysis done using Chi-square cross table on SPSS V 1.0.0.1406

    Time frame: start to end of the study, 1 year

  2. assessment of difference in operation time

    to look for difference in operation time between the two groups, calculated in minutes. analysis done using Student's 2-tailed t-test on SPSS V 1.0.0.1406

    Time frame: start to end of the study, 1 year

07

Study locations

1 site
  • Jordan University Hospital
    Amman, Jubaiha 13046, Jordan
08

References and documents

Publications

  • Reynolds W Jr. The first laparoscopic cholecystectomy. JSLS. 2001 Jan-Mar;5(1):89-94. PubMed 11304004 ↗
  • Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new 'gold standard'? Arch Surg. 1992 Aug;127(8):917-21; discussion 921-3. doi: 10.1001/archsurg.1992.01420080051008. PubMed 1386505 ↗
  • Hypolito OH, Azevedo JL, de Lima Alvarenga Caldeira FM, de Azevedo OC, Miyahira SA, Miguel GP, Becker OM Jr, Machado AC, Nunes Filho GP, Azevedo GC. Creation of pneumoperitoneum: noninvasive monitoring of clinical effects of elevated intraperitoneal pressure for the insertion of the first trocar. Surg Endosc. 2010 Jul;24(7):1663-9. doi: 10.1007/s00464-009-0827-2. Epub 2009 Dec 25. PubMed 20035347 ↗
  • Ozdemir-van Brunschot DM, van Laarhoven KC, Scheffer GJ, Pouwels S, Wever KE, Warle MC. What is the evidence for the use of low-pressure pneumoperitoneum? A systematic review. Surg Endosc. 2016 May;30(5):2049-65. doi: 10.1007/s00464-015-4454-9. Epub 2015 Aug 15. PubMed 26275545 ↗
  • Gohil A. Comparison of low pressure versus standard pressure pneumoperitoneum for elective laparoscopic cholecystectomy in a tertiary care institute of western India. Int Surg J. 2018;5(5):1776. doi:10.18203/2349-2902.isj20181569
  • Celarier S, Monziols S, Francois MO, Assenat V, Carles P, Capdepont M, Fleming C, Rullier E, Napolitano G, Denost Q. Randomized trial comparing low-pressure versus standard-pressure pneumoperitoneum in laparoscopic colectomy: PAROS trial. Trials. 2020 Feb 22;21(1):216. doi: 10.1186/s13063-020-4140-7. PubMed 32087762 ↗
  • Bhattacharjee HK, Jalaludeen A, Bansal V, Krishna A, Kumar S, Subramanium R, Ramachandran R, Misra M. Impact of standard-pressure and low-pressure pneumoperitoneum on shoulder pain following laparoscopic cholecystectomy: a randomised controlled trial. Surg Endosc. 2017 Mar;31(3):1287-1295. doi: 10.1007/s00464-016-5108-2. Epub 2016 Jul 21. PubMed 27444831 ↗
  • Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010 Mar 23;340:c332. doi: 10.1136/bmj.c332. PubMed 20332509 ↗
  • Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi Ch, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc. 2002 Jul;16(7):1121-43. doi: 10.1007/s00464-001-9166-7. Epub 2001 May 20. PubMed 12015619 ↗
  • Hua J, Gong J, Yao L, Zhou B, Song Z. Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic cholecystectomy: a systematic review and meta-analysis. Am J Surg. 2014 Jul;208(1):143-50. doi: 10.1016/j.amjsurg.2013.09.027. Epub 2014 Jan 16. PubMed 24503370 ↗
  • Mandal A, Ghosh A, Bakshi S. Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy: a comparative study. Int Surg J. 2020;7(5):1551. doi:10.18203/2349-2902.isj20201868
  • Mahajan S, Shankar M, Garg VK, Gupta V, Sorout J. Intraoperative safety of low pressure pneumoperitoneum cholecystectomy: a comparative study. Int Surg J. 2017;4(11):3679. doi:10.18203/2349-2902.isj20174885
  • Nasajiyan N, Javaherfourosh F, Ghomeishi A, Akhondzadeh R, Pazyar F, Hamoonpou N. Comparison of low and standard pressure gas injection at abdominal cavity on postoperative nausea and vomiting in laparoscopic cholecystectomy. Pak J Med Sci. 2014 Sep;30(5):1083-7. doi: 10.12669/pjms.305.5010. PubMed 25225531 ↗
  • Agarwal L, Kumawat S, Jain SA, Yadav A, Sharma S. Correlation of shoulder tip pain in case of low pressure and standard pressure pneumoperitoneum post laparoscopic cholecystectomy. Int Surg J. 2021;8(5):1522. doi:10.18203/2349-2902.isj20211820
  • Barczynski M, Herman RM. A prospective randomized trial on comparison of low-pressure (LP) and standard-pressure (SP) pneumoperitoneum for laparoscopic cholecystectomy. Surg Endosc. 2003 Apr;17(4):533-8. doi: 10.1007/s00464-002-9121-2. Epub 2003 Feb 17. PubMed 12582754 ↗
  • Chang W, Yoo T, Cho WT, Cho G. Comparing postoperative pain in various pressure pneumoperitoneum of laparoscopic cholecystectomy: a double-blind randomized controlled study. Ann Surg Treat Res. 2021 May;100(5):276-281. doi: 10.4174/astr.2021.100.5.276. Epub 2021 Apr 29. PubMed 34012945 ↗
  • Moro ET, Pinto PCC, Neto AJMM, Hilkner AL, Salvador LFP, da Silva BRD, Souto IG, Boralli R, Bloomstone J. Quality of recovery in patients under low- or standard-pressure pneumoperitoneum. A randomised controlled trial. Acta Anaesthesiol Scand. 2021 Oct;65(9):1240-1247. doi: 10.1111/aas.13938. Epub 2021 Jun 24. PubMed 34097759 ↗
  • Dr. Vidyanand Tripathi, Dr. Angela B Marak, Dr. Resen Rajan S Methikkalam, Dr. Y Priyabarta Singh, Dr. S Tombisana, Prof. S Ranita Devi PGSM. A Comparative Study Between The Low Pressure Versus Standard Pressure Pneumoperitoneum In Laparoscopic Cholecyst... J Dent Med Sci. 2020;19(7):01-10. doi:10.9790/0853-1907140110
  • Sodhi KS, Saxena AK, Ahuja CK, Rao K, Menon P, Kandelwal N. Postoperative appearances of esophageal atresia repair: retrospective study of 210 patients with review of literature - what the radiologist should know. Acta Radiol. 2013 Mar 1;54(2):221-5. doi: 10.1258/ar.2012.120274. Epub 2012 Nov 1. PubMed 23117198 ↗
  • Kanwer DB, Kaman L, Nedounsejiane M, Medhi B, Verma GR, Bala I. Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy--a randomised controlled trial. Trop Gastroenterol. 2009 Jul-Sep;30(3):171-4. PubMed 20306755 ↗
  • Aggarwal M, Kumar A, Garg S, Pruthi A, Resident S. Effect of Low Pressure Versus High Pressure Pneumoperitoneum on Liver Functions in Laparoscopic Cholecystectomy. Int J Anat Radiol Surg. 2020;9(2):01-03
  • Neogi P, Kumar P, Kumar S. Low-pressure Pneumoperitoneum in Laparoscopic Cholecystectomy: A Randomized Controlled Trial. Surg Laparosc Endosc Percutan Tech. 2020 Feb;30(1):30-34. doi: 10.1097/SLE.0000000000000719. PubMed 31425453 ↗
  • Schietroma M, Carlei F, Mownah A, Franchi L, Mazzotta C, Sozio A, Amicucci G. Changes in the blood coagulation, fibrinolysis, and cytokine profile during laparoscopic and open cholecystectomy. Surg Endosc. 2004 Jul;18(7):1090-6. doi: 10.1007/s00464-003-8819-0. Epub 2004 May 12. PubMed 15136925 ↗
  • Basgul E, Bahadir B, Celiker V, Karagoz AH, Hamaloglu E, Aypar U. Effects of low and high intra-abdominal pressure on immune response in laparoscopic cholecystectomy. Saudi Med J. 2004 Dec;25(12):1888-91. PubMed 15711660 ↗
  • Perrakis E, Vezakis A, Velimezis G, Savanis G, Deverakis S, Antoniades J, Sagkana E. Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2003 Aug;13(4):245-9. doi: 10.1097/00129689-200308000-00004. PubMed 12960786 ↗
  • Torres K, Torres A, Staskiewicz GJ, Chroscicki A, Los T, Maciejewski R. A comparative study of angiogenic and cytokine responses after laparoscopic cholecystectomy performed with standard- and low-pressure pneumoperitoneum. Surg Endosc. 2009 Sep;23(9):2117-23. doi: 10.1007/s00464-008-0234-0. Epub 2008 Dec 6. PubMed 19067057 ↗
  • Manou-Stathopoulou V, Korbonits M, Ackland GL. Redefining the perioperative stress response: a narrative review. Br J Anaesth. 2019 Nov;123(5):570-583. doi: 10.1016/j.bja.2019.08.011. Epub 2019 Sep 20. PubMed 31547969 ↗
  • Kwon YS, Jang JS, Hwang SM, Tark H, Kim JH, Lee JJ. Effects of surgery start time on postoperative cortisol, inflammatory cytokines, and postoperative hospital day in hip surgery: Randomized controlled trial. Medicine (Baltimore). 2019 Jun;98(24):e15820. doi: 10.1097/MD.0000000000015820. PubMed 31192911 ↗
  • Burton D, Nicholson G, Hall G. Endocrine and metabolic response to surgery. Contin Educ Anaesth Crit Care Pain. 2004;4(5):144-147. doi:10.1093/bjaceaccp/mkh040
  • Chernow B, Alexander HR, Smallridge RC, Thompson WR, Cook D, Beardsley D, Fink MP, Lake CR, Fletcher JR. Hormonal responses to graded surgical stress. Arch Intern Med. 1987 Jul;147(7):1273-8. PubMed 3606284 ↗
  • Albers KI, Polat F, Panhuizen IF, Snoeck MMJ, Scheffer GJ, de Boer HD, Warle MC. The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study. Trials. 2020 Jun 17;21(1):541. doi: 10.1186/s13063-020-04496-8. PubMed 32552782 ↗
  • Qin J, Song G, Jiang Y, Liu Q, Lin H. Low-pressure pneumoperitoneum reduces influence on ovarian hormones in infertile women: a randomised trial. Ann Palliat Med. 2021 May;10(5):5746-5753. doi: 10.21037/apm-21-476. Epub 2021 May 17. PubMed 34044564 ↗
  • Aditianingsih D, Mochtar CA, Lydia A, Siregar NC, Margyaningsih NI, Madjid AS, Suwarto S. Effects of low versus standard pressure pneumoperitoneum on renal syndecan-1 shedding and VEGF receptor-2 expression in living-donor nephrectomy: a randomized controlled study. BMC Anesthesiol. 2020 Feb 4;20(1):37. doi: 10.1186/s12871-020-0956-7. PubMed 32019488 ↗
  • Rashdan M, Daradkeh S, Al-Ghazawi M, Abuhmeidan JH, Mahafthah A, Odeh G, Al-Qaisi M, Salameh I, Halaseh S, Al-Sabe L, Ahmad YB, Al-Ghazawi T, Al-Said M, Sha'bin S, Mansour H. Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial. BMC Res Notes. 2023 Sep 28;16(1):235. doi: 10.1186/s13104-023-06492-y. PubMed 37770908 ↗

Study documents

  • Study protocol · Jan 15, 2020
  • Statistical analysis plan · Jan 1, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jan 2020 to primary completion in Jan 2021, 12 months.

Of 44 non-industry interventional studies with no phase under Pneumoperitoneum, half reached primary completion within 8 months of starting (the median), counting those still running; a quarter within 4 and three quarters within 14. This study's 12 months is above that.

Counting every sponsor, half of 45 studies reached it within 8 months; a quarter within 4 and three quarters within 14.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 27, 2022
First posted
Sep 7, 2022
StartActual
Jan 1, 2020
Primary completionActual
Jan 30, 2021
CompletionActual
Jan 30, 2021
Last update
Sep 7, 2022
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 7, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05530564
Responsible party
Hanan Ibrahim Mansour (Dr. Hanan Mansour, M.D., University of Jordan) — Principal investigator
First posted
Sep 7, 2022
Start date
Jan 1, 2020
Primary completion
Jan 30, 2021
Completion
Jan 30, 2021
Last update
Sep 7, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2022. You cannot join it, but the record below documents what was studied.

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