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[Structure, function, and levels of neutrophil elastase after laparoscopic cholecystectomy]
M Schietroma1, M Rossi, C A Tinca
1Divisione di Chirurgia Geriatrica, Facoltà di Medicina e Chirurgia, Università degli Studi di L'Aquila.
Chirurgia Italiana
|February 24, 2001
Summary
Neutrophil elastase levels indicate surgical trauma severity. Open cholecystectomy causes a significant increase, unlike laparoscopic surgery, suggesting better leukocyte preservation after minimally invasive procedures.
Area of Science:
- Biochemistry
- Immunology
- Surgical Research
Context:
- Neutrophil elastase (NE) is a key enzyme in inflammatory responses, released by polymorphonuclear leukocytes.
- Surgical trauma elicits inflammatory reactions, potentially measurable by biomarkers like NE.
- Comparing open vs. laparoscopic cholecystectomy provides a model to assess trauma-induced biomarker changes.
Purpose:
- To investigate plasma neutrophil elastase as a marker for surgical trauma severity.
- To compare NE levels following open cholecystectomy versus laparoscopic cholecystectomy.
- To evaluate the impact of surgical approach on peripheral leukocyte function.
Summary:
- Plasma NE levels significantly increased 1, 3, and 6 days post-surgery in open cholecystectomy patients (p < 0.05).
- Laparoscopic cholecystectomy patients showed stable plasma NE levels, indicating less severe trauma.
- Two respiratory tract infections occurred in the open surgery group, correlating with higher NE levels.
Impact:
- Neutrophil elastase serves as a reliable indicator to differentiate surgical trauma severity between open and laparoscopic procedures.
- Laparoscopic surgery appears to preserve peripheral leukocyte function better than open surgery.
- Findings support NE's utility in assessing surgical stress and guiding patient management.