Immunosuppression after cholecystectomy

The effect on immune functions of cholecystectomy under combined anaesthesia was studied in nine patients. The parameters examined were the leucocyte and differential count, the T-and B-lymphocyte count, and the lymphocyte transformation induced by phytohaemagglutinin, concanavalin A, pokeweed mitogen and purified protein derivative of tuberculoprotein. The anaesthesia and operation decreased the total lymphocyte count in the peripheral blood. No significant change occurred in the proportion or absolute number of E-binding (T) lymphocytes. The proportion of EAC-binding (B) lymphocytes increased, although no change was observed in the lymphocytes with surface immunoglobulin representing another B-cell marker. A statistically significant decrease was found in the lymphocyte response to all the mitogens used both in cultures with isolated lymphocytes and in whole blood. The changes returned to the pre-induction level on the third postoperative day. These finding suggest a transitory decrease of cell-mediated immunity after cholecystectomy.