The neutrophils response after laparoscopic and open cholecystectomy

Area of Science:

• General Surgery
• Surgical Inflammation
• Biomarker Analysis

Background:

• Cholecystectomy is a common surgical procedure.
• Inflammatory responses post-surgery can indicate complications.
• Comparing open and laparoscopic approaches is crucial for patient outcomes.

Purpose of the Study:

• To investigate modifications in neutrophils, neutrophil-elastase, C-reactive protein (CRP), and Interleukin-6 (IL-6) after open and laparoscopic cholecystectomy.
• To determine if these inflammatory markers predict infectious complications.

Main Methods:

• Measured serum IL-6, CRP, and neutrophil-elastase in 71 patients undergoing cholecystectomy.
• Patients received no anti-spasmodic, steroid, or NSAID treatment during hospitalization.
• Diagnosis was confirmed via ultrasound.

Main Results:

• Laparoscopic cholecystectomy demonstrated significantly smaller increases in IL-6 and neutrophil-elastase compared to open surgery.
• Postoperative CRP elevations were less pronounced after laparoscopic procedures.
• Three cases (8.5%) of infection occurred in the open surgery group; neutrophil-elastase normalized later in patients with complications.

Conclusions:

• Significant associations exist between IL-6, CRP, and neutrophil-elastase response patterns.
• Neutrophil-elastase is a more sensitive inflammatory marker than IL-6 and CRP.
• Prolonged elevations of these mediators post-surgery correlate with increased morbidity.