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Changes in T-lymphocytes' viability after laparoscopic versus open cholecystectomy
Ilias P Gomatos1, Leonidas Alevizos, Olga Kalathaki
1Laboratory of Surgical Research, 1st Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece.
International Surgery
|April 16, 2015
Summary
Laparoscopic surgery better preserves peripheral T-lymphocytes compared to open surgery, with less necrosis observed post-procedure. Open cholecystectomy leads to increased T-lymphocyte death primarily through necrosis, peaking at 24 hours.
Area of Science:
- Surgical Oncology
- Immunology
- Cell Biology
Background:
- Laparoscopic surgery generally causes less immune and metabolic stress than open surgery.
- Understanding the impact on host immune defense is crucial for surgical outcomes.
Purpose of the Study:
- To compare the effects of laparoscopic versus open cholecystectomy on peripheral T-lymphocyte apoptosis, necrosis, and survival.
- To evaluate the host immune defense suspension following these surgical procedures.
Main Methods:
- Flow cytometry was used to measure apoptosis, necrosis, and viability of peripheral T-lymphocytes.
- Measurements were taken preoperatively and postoperatively in patients undergoing laparoscopic (n=27) or open (n=25) cholecystectomy.
- White blood cell count, C-reactive protein (CRP), and serum glucose were also monitored.
Main Results:
- Open cholecystectomy significantly decreased viable T-lymphocytes and increased late apoptotic and necrotic rates (P < 0.01).
- Compared to laparoscopic surgery, open cholecystectomy showed lower surviving T-lymphocytes and higher necrotic T-lymphocytes at 24 hours (P = 0.01-0.03).
- Serum CRP increased post-open cholecystectomy (P = 0.04), with all differences resolving within 48 hours.
Conclusions:
- Laparoscopic cholecystectomy promotes T-lymphocyte viability and reduces necrosis.
- Necrosis, not apoptosis, is the primary mechanism of T-lymphocyte death after open cholecystectomy.
- These immune effects are most pronounced at 24 hours post-surgery and diminish by 48 hours.
