title: Preoperative oral feeding reduces stress response after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Fasting period before surgery may change metabolic status of the patient and have influence on perioperative stress response. The aim of the study was to investigate effects of preoperative carbohydrate-rich beverage on stress response after laparoscopic cholecystectomy.
  
  
  METHODS
  Patients admitted for laparoscopic cholecystectomy were included into study and they were randomized into a group that was fed prior to surgery and in a group that was in the regime of nothing by mouth from the evening one day before surgery. Concentrations of C-reactive protein and cortisol, were measured before and subsequently up to 48 h postoperatively.
  
  
  RESULTS
  Postoperative serum C-reactive protein increased significantly in both groups, but the increase was more evident in the group with fasting protocol both 24 and 48 hours postoperatively. In fed patients cortisol concentration measured in the afternoon immediately after the operation showed physiological decline. In patients with fasting protocol postoperative cortisol values rise above the values measured in the morning.
  
  
  CONCLUSIONS
  Preoperative feeding has advantage over overnight fasting by reducing preoperative discomfort in patients after laparoscopic cholecystectomy. In fed patients, smaller increase in C-reactive protein and better regulation of cortisol levels are an indicator of decreased perioperative stress response.
authors.forename: Marko
authors.initials: M
authors.lastname: Zelić
authors.forename: Davor
authors.initials: D
authors.lastname: Štimac
authors.forename: Davor
authors.initials: D
authors.lastname: Mendrila
authors.forename: Vlatka Sotošek
authors.initials: VS
authors.lastname: Tokmadžić
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Fišić
authors.forename: Miljenko
authors.initials: M
authors.lastname: Uravić
authors.forename: Alan
authors.initials: A
authors.lastname: Šustić
mesh_terms: D000284:Administration, Oral; D001628:Beverages; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D017523:Croatia; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004311:Double-Blind Method; D004750:Enteral Nutrition / Q000379:methods*; D005215:Fasting; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care; D013312:Stress, Physiological; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D004040:Dietary Carbohydrates; D002097:C-Reactive Protein; D006854:Hydrocortisone