The metabolic response to cholecystectomy: insulin resistance after open compared with laparoscopic operation.
OBJECTIVE
To study the changes in insulin sensitivity and plasma concentrations of interleukin-6 (IL-6) after open compared with laparoscopic cholecystectomy.


METHODS
Prospective open study.


METHODS
University hospital, Sweden.


METHODS
12 otherwise healthy patients undergoing either open (n = 6) or laparoscopic (n = 6) cholecystectomy.


METHODS
Relative insulin sensitivity (compared with preoperative) on the day after operation. Changes in IL-6 concentrations postoperatively.


RESULTS
The mean (SEM) relative reduction in insulin sensitivity was significantly smaller after laparoscopic (18 (5)%) compared with the open operation, (58 (4)%) (p < 0.01). There was a significant increase in plasma concentrations of IL-6 postoperatively, but there was no difference between the groups.


CONCLUSIONS
Insulin sensitivity is less affected 24 hours after laparoscopic than after open cholecystectomy, which in this study was not accompanied by a simultaneous difference in the IL-6 response. The small postoperative reduction of insulin sensitivity may be a contributing factor to the clinical benefit of improved wellbeing observed after laparoscopic surgery.
Thorell
A
A
Department of Surgery, Karolinska Hospital & Institute, Stockholm, Sweden.
Nygren
J
J
Essén
P
P
Gutniak
M
M
Loftenius
A
A
Andersson
B
B
Ljungqvist
O
O
D000328:Adult; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011446:Prospective Studies
D015850:Interleukin-6