The stress response to laparoscopic cholecystectomy: investigation of endocrine parameters.
Laparoscopic cholecystectomy, as a typical example of minimal invasive surgery, is associated with low complication rates and minimal patient discomfort, and provides the same safety as conventional cholecystectomy. In the present prospective observational study, endocrine parameters as indicators for stress response were measured. We investigated 53 patient with laparoscopy cholecystectomy and 12 patients with conventional cholecystectomy. Blood samples were taken pre-, peri-, and postoperatively for measurement of ACTH, cortisol, prolactin, and growth hormone. General anesthesia followed a standardized protocol. The increase in all stress hormones did not differ between patients in the two groups, and was comparable with that reported in the literature and the findings of our own previous studies in patients undergoing conventional cholecystectomy and elective colon resection. We conclude that laparoscopic cholecystectomy is associated with a pronounced endocrine stress response that does not account for the observed differences in the peri- and postoperative complication rate or patient comfort.
Deuss
U
U
Department of Internal Medicine II, University of Cologne, Germany.
Dietrich
J
J
Kaulen
D
D
Frey
K
K
Spangenberger
W
W
Allolio
B
B
Matuszczak
M
M
Troidl
H
H
Winkelmann
W
W
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011388:Prolactin / Q000097:blood*; D011446:Prospective Studies; D013312:Stress, Physiological / Q000097:blood* / Q000209:etiology
D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D013006:Growth Hormone; D006854:Hydrocortisone