Results
obstructive jaundice, blood loss, vomiting, pain, small bowel obstruction
INTRAOPERATIVE COMPLICATIONS, OBSTRUCTIVE JAUNDICE, BLOOD LOSS, MINOR, ELECTROLYTE DISTURBANCE, SECONDARY, SMALL BOWEL OBSTRUCTION, PNEUMOPERITONEUM
A hundred patients were included in the analysis, with 50 patients in each study arm (n = 50). (Graph 1) The sample was normally distributed. Age and BMI were analyzed using Student’s t-test (Table 
Group characteristics INo significant difference in mean between both groups in terms of age and BMI*
Group characteristics IINo significant difference in mean between both groups in terms of gender, smoking status and ASA score*The mean duration of total operative time, insufflation time, and mean hospital-stay were similar across groups with no significant difference. Analysis done using Student’s t-test (Table 
Operation observationsNo significant difference in mean between both groups in terms of total operative time, insufflation time and post-op hospital stay*None of the groups had major intraoperative complications. Three patients in the low-pressure group had a change of pneumoperitoneum initial set of pressure: two patients due to operating surgeon inexperience (senior resident) and one due to uncommon anatomy of the callout’s triangle. None had conversion to open cholecystectomy, none had more than minor intra-op blood loss, and none of the patients died during the study period. Four patients were readmitted within the 30-day period post-op: one patient from the standard-pressure group had severe vomiting and electrolyte disturbance that required in-hospital fluid resuscitation, two patients from the low-pressure group developed obstructive jaundice secondary to common bile duct (CBD) stones that required endoscopic intervention, another patient from the low-pressure group developed small bowel obstruction secondary to trocar site evisceration which was treated with reoperation and laparoscopic repair.There was no significant difference in difficulty of surgery between low-pressure and standard-pressure groups, with a 
Difficulty of surgery and operator level of experienceNo significant difference between both groups in terms of surgery difficulty and operator level of experience*The mean intensity of pain was lower and showed significant difference at the 6-hour post-op time point in the low-pressure group with a 
Post-operative pain score A significant difference was observed between the two groups in pain score collected at 6-hour post-op time point with a *
Line graph of post-operative pain score[Red line represents standard-pressure group, green line represents low-pressure group. A difference is observed at the 6-hour time point, but the mean of pain score at 12-hour and 24-hour time points is equal]
Box plot of post-operative pain at 6-houre[showing box plot of pain score at 6-hour time point, the horizontal line represents median score which is different between the two groups]Inflammatory markers were assessed pre and post operatively for both groups using Welch’s t-test and a 
Inflammatory markers levelsWBC(10Platelet(10ESR(mm/ hr)CRP(mg/L)Albumin(g/dL)Cortisol(nmol/L)IL-6(pg/mL)IL-17(pg/mL)IL1-β(pg/mL)TNF-α(pg/mL)Highlighted significant difference observed in level of inflammatory marker*
Box plot of mean difference in free serum cortisol level[Box plot shows difference in the median of change in free cortisol levels between the two groups standard Vs low pressure group, with significant difference]Subgroup analysis was done to eliminate the effect of dexamethasone administered by anesthesia team at the time of anesthesia induction. Patients were classified into two groups: those that were given dexamethasone and those who were not (Graph 1). Analysis done using Welch’s t-test. The results showed persistence of significant difference in the free serum cortisol level in favor of standard pressure group. (Tables 
Inflammatory markers levels, subgroup analysis for dexamethasoneWBC(10Platelet(10ESR(mm/ hr)CRP(mg/L)Albumin(g/dL)Cortisol(nmol/L)IL-6(pg/mL)IL-17(pg/mL)IL-1β(pg/mL)TNF-α(pg/mL)Showing difference in inflammatory markers for patients not given dexamethasone injection at induction of surgery. No significant difference was observed across groups*
Inflammatory markers levels, subgroup analysis for dexamethasoneWBC(10Platelet(10ESR(mm/ hr)CRP(mg/L)Albumin(g/dL)Cortisol(nmol/L)IL-6(pg/mL)IL-17(pg/mL)IL-1β(pg/mL)TNF-α(pg/mL)Showing difference in inflammatory markers for patients given dexamethasone injection at induction of surgery. Significant difference in cortisol level was observed across groups*