title: Response of serum cytokines in patients undergoing laparoscopic cholecystectomy.
abstract: The clinical observation that a laparoscopic cholecystectomy is a minimally invasive operation has not been demonstrated on a biochemical basis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulating protein, correlates with the significance of surgical trauma. Utilizing the IL-6 immunoassay, we studied this biochemical parameter of trauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only laparoscopic cholecystectomy showed peak IL-6 concentrations of 51 pg/ml (22-86) vs a peak IL-6 concentration of 124 pg/ml (56-225) for open cholecystectomy. Six additional patients who underwent an ERCP followed by laparoscopic cholecystectomy showed a dramatic rise in peak IL-6 concentration to 315 pg/ml (15-634). These results biochemically confirm the true minimal invasiveness of laparoscopic cholecystectomy. The findings in the ERCP-followed-by-laparoscopic-cholecystectomy group support the theory that two invasive procedures in close proximity may prime the cytokine system in its response to surgical trauma.
authors.affiliation: Department of Surgery, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.
authors.forename: J M
authors.initials: JM
authors.lastname: Cho
authors.forename: A J
authors.initials: AJ
authors.lastname: LaPorta
authors.forename: J R
authors.initials: JR
authors.lastname: Clark
authors.forename: M J
authors.initials: MJ
authors.lastname: Schofield
authors.forename: S L
authors.initials: SL
authors.lastname: Hammond
authors.forename: P L
authors.initials: PL
authors.lastname: Mallory
mesh_terms: D016063:Blood Loss, Surgical; D002097:C-Reactive Protein / Q000032:analysis; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D006801:Humans; D007124:Immunoenzyme Techniques; D015850:Interleukin-6 / Q000097:blood*; D016717:Sphincterotomy, Endoscopic; D013997:Time Factors
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein