Disturbances of gastric electrical control activity after laparotomic cholecystectomy are related to interleukin-6 concentrations.
BACKGROUND
The aim of the present study was to characterize the disturbances of gastric electrical control activity after cholecystectomy and to correlate electrogastrographic (EGG) findings with inflammatory markers.


METHODS
52 adult patients were examined in conjunction with planned laparotomic or laparoscopic cholecystectomy. Gastric myoelectrical activity was recorded with a MicroDigitrapper device using three Ag-AgCl disposable skin electrodes. The dominant frequency was calculated using computerized algorithms. Repeated EGG records were correlated with inflammatory parameters - interleukin-6 (IL-6), tumor necrosis factor-alpha, procalcitonin, and C-reactive protein.


RESULTS
Both basal and stimulated gastric electrical frequency decreased significantly in the postoperative phase measured 6 h after the start of surgery (p < 0.01). Postoperative bradygastria (electrical control activity frequency <2.4 cpm) was relatively more expressed after open cholecystectomy. Among the patients with a laparotomic cholecystectomy, IL-6 maximal postoperative concentrations correlated positively with a prolonged restitution of normal gastric activity.


CONCLUSIONS
EGG examination showed a high sensitivity in the evaluation of gastric electrical activity after both laparotomic and laparoscopic cholecystectomy. A significant correlation of prolonged bradygastria and IL-6 plasma levels supports the role of the inflammatory milieu in the pathogenesis of impaired gastric electrical activity in the postoperative period.
Maruna
P
P
Institute of Pathological Physiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. maruna@LF1.cuni.cz
Frasko
R
R
Lindner
J
J
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004568:Electrodiagnosis; D055724:Electrophysiological Phenomena; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology*; D011446:Prospective Studies; D013270:Stomach / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein