The influence of laparoscopy on lymphocyte subpopulations in the surgical patient.
BACKGROUND
Surgical stress is known to disturb the immune system so that the overall picture is one of generalized immunosuppression proportional to the degree of stress. It has been suggested that minimally invasive procedures, i.e., laparoscopic cholecystectomy, should be accompanied by decreased surgical stress.


METHODS
The present study utilized a panel of monoclonal antibodies to identify peripheral blood lymphocyte subpopulations in 11 patients scheduled for elective laparoscopic cholecystectomy. These were obtained immediately preoperatively, one day postoperatively, and one week postoperatively.


RESULTS
The results demonstrated a significant (p < 0.05) decrease in T-helper to T-suppressor cell ratios the first day postoperatively compared to the preoperative ratios; the mean decrease was 13% below the preoperative ratios. There was no significant change in the ratios one week postoperatively.


CONCLUSIONS
Even though laparoscopic cholecystectomy has been documented to have less disability and postoperative pain than open cholecystectomy, alterations in immune function, although attenuated, do persist.
Vallina
V L
VL
Department of Surgery, Rush University and Rush North Shore Medical Center, 9600 Gross Point Road, Skokie, IL 60076, USA.
Velasco
J M
JM
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D016516:CD4-CD8 Ratio; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013312:Stress, Physiological / Q000276:immunology; D016176:T-Lymphocyte Subsets
D000911:Antibodies, Monoclonal