Hormone-cytokine response. Pneumoperitoneum vs abdominal wall-lifting in laparoscopic cholecystectomy.
BACKGROUND
Changes in blood hormone and cytokine were investigated in patients who underwent laparoscopic cholecystectomy via insufflation (CO2 group) vs those who had abdominal wall-lifting (Air group).


METHODS
Seventeen female patients with cholecystolithiasis were randomly divided into two groups. Peripheral blood samples were obtained during perioperative period, and plasma hormone levels (ACTH, cortisol) and serum cytokine levels (TNFalpha, IL-1beta, IL-6, IL-10) were measured.


RESULTS
The number of circulating lymphocytes significantly decreased at 1 h after surgery in both groups, but the decrease in the CO2 group was significantly smaller than that in the Air group. There was no significant difference in hormone elevation between groups. Serum concentrations of IL-6 and IL-10 in the Air group were significantly higher than in the CO2 group.


CONCLUSIONS
CO2 insufflation may reduce cytokine production in laparoscopic cholecystectomy.
Yoshida
T
T
Department of Surgery, Omiya Medical Center, Jichi Medical School, 3311-1 Kawati-gun, Tochigi 329-04, Japan.
Kobayashi
E
E
Suminaga
Y
Y
Yamauchi
H
H
Kai
T
T
Toyama
N
N
Kiyozaki
H
H
Fujimura
A
A
Miyata
M
M
D000009:Abdominal Muscles / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000097:blood / Q000601:surgery*; D016207:Cytokines / Q000097:blood* / Q000378:metabolism; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood* / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011379:Prognosis; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D005768:Gastrointestinal Hormones; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002245:Carbon Dioxide; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone