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Diminished interleukin-6 and C-reactive protein responses to laparoscopic versus open cholecystectomy.

Abstract：

BACKGROUND:Cytokines and their inhibitors are thought to be involved in many of the pathophysiological changes associated with trauma and infection. The magnitude of the trauma and the degree of tissue damage have an impact on the trauma response. The purpose of the study was to examine cytokine and hormonal responses to elective cholecystectomy and the extent to which these responses are influenced by the surgical procedure employed. METHODS:Sixteen patients, ASA grades I and II, were studied: 8 of them underwent laparoscopic cholecystectomy while the remaining 8 were operated on using the open technique. Systemic concentrations of tumour necrosis factor alpha (TNF), interleukin-1 beta (IL-1), interleukin-6 (IL-6), cortisol, epinephrine and norepinephrine were measured before and during the operation and subsequently for up to 48 h postoperatively. The degree of pain and fatigue were recorded during the study period. RESULTS:The preoperative levels of cytokines and hormones were all similar in the groups. Concentrations of TNF and IL-1 were detected only sporadically. The rise in plasma IL-6 was less marked following laparoscopic than after open cholecystectomy. However, the hormonal response was quite similar in the two groups. Pain and fatigue scores were lower (P < 0.05-0.01) in the laparoscopic group than in the open surgery group. CONCLUSION:In summary, cholecystectomy, irrespective of whether it was performed using the laparoscopic or open technique, was followed by a trauma response and increased pain and fatigue. However, the magnitude of stress, pain and fatigue was less pronounced in laparoscopic cholecystectomy patients. Concentrations of IL-6 seem to be more sensitive when it comes to delineating the trauma response than systemic norepinephrine and epinephrine levels.

journal_name

Acta Anaesthesiol Scand

journal_title

Acta anaesthesiologica Scandinavica

authors

Kristiansson M,Saraste L,Soop M,Sundqvist KG,Thörne A

doi

10.1034/j.1399-6576.1999.430205.x

subject

Has Abstract

pub_date

1999-02-01 00:00:00

pages

146-52

issue

eissn

0001-5172

issn

1399-6576

journal_volume

pub_type

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Diminished interleukin-6 and C-reactive protein responses to laparoscopic versus open cholecystectomy.