title: Systemic immune response after laparoscopic and open cholecystectomy.
abstract: The laparoscopic approach is thought to reduce the postoperative immunologic and metabolic effects of an open operation. This study was designed with the aim of comparing the systemic immune response after laparoscopic and open cholecystectomy. Seventeen patients with gallbladder stones were assigned to undergo either a laparoscopic (n = 9) or open (n = 8) approach. The postoperative immune response was assessed by measuring the serum levels of soluble Fas (sFas), soluble L-selectin (sL-selectin), and transforming growth factor-beta1 (TGFbeta1) preoperatively and 2 hours, 1 day, and 2 days postoperatively. Both approaches resulted in a significant decrease in sFas levels 1 and 2 days postoperatively. The open approach evoked a transient increase in sL-selectin levels 2 hours postoperatively. Moreover, the open approach resulted in a persistent, significant increase in TGFbeta1 levels postoperatively. Comparison of open versus laparoscopic cholecystectomy has shown no significant difference in sFas level and a statistically significant increase of sL-selectin (within 2 hours) and TGFbeta levels after open surgery. Although both laparoscopic and open cholecystectomy evoked an alteration of the systemic immune response, our data showed that such immune response may be less after the laparoscopic approach.
authors.affiliation: Department of Surgery, Division of General Surgery, Colon and Rectal Surgery, Chang Gung Memorial Hospital, Kaohsiung College of Medicine, Chang Gung University, Kaohsiung 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan. smshen@yahoo.com
authors.forename: Shyr-Ming
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: Han-Shiang
authors.initials: HS
authors.lastname: Chen
authors.forename: Hock-Liew
authors.initials: HL
authors.lastname: Eng
authors.forename: Wei-Jen
authors.initials: WJ
authors.lastname: Chen
authors.forename: Bruno
authors.initials: B
authors.lastname: Jawan
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002764:Cholecystitis / Q000276:immunology* / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007109:Immunity / Q000502:physiology; D019041:L-Selectin / Q000097:blood*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008233:Lymphotoxin-alpha / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017562:Postcholecystectomy Syndrome / Q000453:epidemiology / Q000276:immunology*; D011336:Probability; D011446:Prospective Studies; D012494:Sampling Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D008233:Lymphotoxin-alpha; D019041:L-Selectin