Serum interleukin-6 and C reactive protein responses in patients after laparoscopic or conventional cholecystectomy.
OBJECTIVE
To investigate the acute phase inflammatory response to surgical trauma after laparoscopic and conventional cholecystectomy.


METHODS
Prospective open study.


METHODS
University Hospital in The Netherlands.


METHODS
21 patients with symptomatic cholelithiasis admitted for elective cholecystectomy who had had no previous upper abdominal operations.


METHODS
12 patients underwent conventional, and 9 patients laparoscopic, cholecystectomy. Circulating interleukin-6 (IL-6) and C reactive protein concentrations were measured 6, 12, 24 and 48 hours after operation.


METHODS
Changes in IL-6 and C reactive protein concentrations, and comparison of operative blood loss and length of stay in hospital.


RESULTS
Those treated by laparoscopic cholecystectomy lost significantly less blood (median 60 compared to 100 ml) and spent significantly fewer days in hospital (median 2 compared with 7 days), (p < 0.01 in each case). The only changes in circulating IL-6 concentrations were seen in patients over the age of 60 years who underwent conventional cholecystectomy. There were significant differences in C reactive protein concentrations between the two operations at both 24 and 48 hours after the operation (p < 0.01 in each case).


CONCLUSIONS
We conclude that laparoscopic cholecystectomy reduces the acute phase inflammatory response compared with the conventional operation; there seems to be no relevant correlation between plasma concentrations of IL-6 and C reactive protein; the presence of IL-6 does not affect the response of C reactive protein to trauma; and the response of IL-6 to trauma is age dependent.
Roumen
R M
RM
Department of General Surgery, University Hospital Nijmegen, The Netherlands.
van Meurs
P A
PA
Kuypers
H H
HH
Kraak
W A
WA
Sauerwein
R W
RW
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors
D015850:Interleukin-6; D002097:C-Reactive Protein