Effects of cholecystectomy (laparoscopic versus open) on PMN-elastase

Area of Science:

• Biochemistry
• Immunology
• Surgical Research

Background:

• Polymorphonuclear leukocytes (PMN) are key in inflammatory responses.
• Surgical trauma releases PMN-elastase, a potential indicator of injury severity.
• Laparoscopic cholecystectomy (LC) is minimally invasive compared to open cholecystectomy (OC).

Purpose of the Study:

• To compare serum PMN-elastase levels in LC versus OC patients.
• To assess if PMN-elastase levels correlate with infectious complications after cholecystectomy.
• To evaluate the clinical significance of PMN-elastase as a surgical trauma marker.

Main Methods:

• Plasma elastase and C-reactive protein (CRP) were measured in 86 patients (42 OC, 44 LC) using photometric and ELISA methods.
• Blood samples were collected pre-operatively and on days 1, 3, 6, and 12 post-operatively.
• A reference range for elastase was established using 68 healthy controls.

Main Results:

• OC patients showed significant increases in plasma elastase on days 1, 3, and 6 post-surgery (p < 0.05).
• LC patients exhibited minimal changes in elastase levels.
• Serum CRP levels and postoperative infection rates were significantly lower in the LC group compared to the OC group.

Conclusions:

• Laparoscopic cholecystectomy preserves peripheral leukocyte function better than open cholecystectomy.
• Minimally invasive surgery reduces surgical stress and improves postoperative outcomes.
• Elevated PMN-elastase and CRP indicate increased morbidity; PMN-elastase is a sensitive inflammation marker.