Response of serum cytokines in patients undergoing laparoscopic cholecystectomy.
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.
Cho
J M
JM
Department of Surgery, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.
LaPorta
A J
AJ
Clark
J R
JR
Schofield
M J
MJ
Hammond
S L
SL
Mallory
P L
PL
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
D015850:Interleukin-6; D002097:C-Reactive Protein