Adhesion formation with open versus laparoscopic cholecystectomy: an immunologic and histologic study.
BACKGROUND
This randomized study aimed to compare the reaction of the immune system to the process of postoperative adhesion formation after open and laparoscopic cholecystectomy.


METHODS
In this study, 20 mongrel dogs were used: 10 each in the laparoscopic and open cholecystectomy groups. Blood and peritoneal lavage samples were taken up to postoperative day 14, followed by second-look laparoscopy and reoperation to detect the rate of adhesion formation. Also, specimens were obtained from the liver bed for histology.


RESULTS
In the open cholecystectomy group, the white blood cell count was higher in blood samples and lower in lavage specimens. Adhesion formation was extensive, and the histologic immune reaction was more intensive in the open cholecystectomy group.


CONCLUSIONS
This randomized study proved that laparoscopic cholecystectomy was associated with less immune suppression, less inflammatory reaction, and therefore less adhesion formation than open cholecystectomy.
Szabó
Gy
G
Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary. szabogyo@richter.hu
Mikó
I
I
Nagy
P
P
Bráth
E
E
Peto
K
K
Furka
I
I
Gamal
E M
EM
D000818:Animals; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002764:Cholecystitis / Q000601:surgery; D004195:Disease Models, Animal; D005260:Female; D007111:Immunity, Cellular / Q000502:physiology*; D008297:Male; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000276:immunology* / Q000473:pathology*; D011336:Probability; D011897:Random Allocation; D012086:Reoperation; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000276:immunology / Q000473:pathology