Comparison of metabolic responses to laparoscopic and minilaparotomy cholecystectomy.
This randomized study compared the metabolic responses to laparoscopic cholecystectomy (n = 10) and minilaparotomy cholecystectomy with a 5-7-cm incision (n = 10). Venous blood samples were taken before operation and at 3, 6, 9, 12, 18, 24, 48, 72 and 168 h after incision and analysed for levels of C-reactive protein, interleukin 6, cortisol, albumin, transferrin, iron, fibrinogen, fibrin degradation products and polymorphonuclear elastase, and for neutrophil and lymphocyte counts. Urine samples (24 h) were analysed for urea, creatinine, 3-methylhistidine and catecholamines. The magnitude of the metabolic changes from baseline levels was quantified by calculating areas under each individual curve. A significant metabolic response with a similar time course and magnitude of changes occurred after laparoscopic and minilaparotomy cholecystectomy but with wide variation in magnitude between individuals.
McMahon
A J
AJ
University Departments of Surgery, Western Infirmary, Glasgow, UK.
O'Dwyer
P J
PJ
Cruikshank
A M
AM
McMillan
D C
DC
O'Reilly
D S
DS
Lowe
G D
GD
Rumley
A
A
Logan
R W
RW
Baxter
J N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007501:Iron / Q000378:metabolism; D008297:Male; D008660:Metabolism / Q000502:physiology*; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
D015850:Interleukin-6; D014168:Transferrin; D005340:Fibrinogen; D002097:C-Reactive Protein; D007501:Iron; D010196:Pancreatic Elastase; D006854:Hydrocortisone