Systemic immune response after laparoscopic and open cholecystectomy.
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.
Sheen-Chen
Shyr-Ming
SM
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
Chen
Han-Shiang
HS
Eng
Hock-Liew
HL
Chen
Wei-Jen
WJ
Jawan
Bruno
B
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
D008233:Lymphotoxin-alpha; D019041:L-Selectin