title: Inflammatory response measured by body temperature, C-reactive protein and white blood cell count 1, 3, and 5 days after laparotomic or laparoscopic gastric bypass surgery.
abstract: BACKGROUND
  Morbid obesity is a chronic inflammatory condition due to the production of several cytokines from the adipose tissue. However, what happens with some of these parameters the first days after surgery is unknown. Therefore, the objective of the present study was to determine, through a prospective and descriptive study, the behavior of the C-reactive protein (CRP), the white blood cell count, and the body temperature prior to a gastric bypass and for 5 days afterwards.
  
  
  METHODS
  A total of 156 patients with morbid obesity were included in this prospective study. There were 120 women and 36 men, with a mean age of 41 years and a body mass index of 43 kg/m(2). They were submitted either to a laparotomic resectional gastric bypass or to a laparoscopic gastric bypass. Body temperature was measured every 8 h during 5 days. CPR and white blood cells were measured at the first, third, and fifth day after surgery.
  
  
  RESULTS
  All patients had a normal postoperative course. Body temperature showed no change. White blood cells increased significantly at the first and third day after surgery but normalized by the fifth day. However, the third day after surgery, laparotomic gastric bypass patients showed a significantly greater increase in the total white blood cell count as well as in segmented neutrophil cells compared to laparoscopic surgery patients. CRP exhibited a similar increase and was more pronounced after a laparotomic approach.
  
  
  CONCLUSIONS
  During the 5 days after gastric bypass, a significant increase in white blood cells and CRP was observed. The increase was significantly greater after a laparotomic bypass compared to the laparoscopic approach.
authors.affiliation: Department Of Surgery, University Hospital, University Of Chile, Santiago, Chile. acsendes@redclinicauchile.cl
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Burgos
authors.forename: Daniel
authors.initials: D
authors.lastname: Roizblatt
authors.forename: Claudio
authors.initials: C
authors.lastname: Garay
authors.forename: Pablo
authors.initials: P
authors.lastname: Bezama
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D010535:Laparoscopy; D007813:Laparotomy; D007958:Leukocyte Count; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein