title: The metabolic response to cholecystectomy: insulin resistance after open compared with laparoscopic operation.
abstract: 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.
authors.affiliation: Department of Surgery, Karolinska Hospital & Institute, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Thorell
authors.forename: J
authors.initials: J
authors.lastname: Nygren
authors.forename: P
authors.initials: P
authors.lastname: Essén
authors.forename: M
authors.initials: M
authors.lastname: Gutniak
authors.forename: A
authors.initials: A
authors.lastname: Loftenius
authors.forename: B
authors.initials: B
authors.lastname: Andersson
authors.forename: O
authors.initials: O
authors.lastname: Ljungqvist
mesh_terms: D000328:Adult; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011446:Prospective Studies
chemical_list: D015850:Interleukin-6