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[Surgical trauma from laparoscopic cholecystectomy]

J M Bolufer Cano1, F Delgado Gomis, F Blanes Masson

  • 1Servicio de Cirugía General y Digestivo, Hospital Dr. Peset, Valencia, España.

Nutricion Hospitalaria
|July 1, 1995
PubMed
Summary

Laparoscopic cholecystectomy results in a lower neuroendocrine stress response compared to open surgery. This study quantifies surgical aggression by measuring hormone levels post-operation.

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Area of Science:

  • Endocrinology
  • Surgical Research
  • Minimally Invasive Surgery

Background:

  • Surgical procedures elicit a neuroendocrine stress response.
  • Laparoscopic cholecystectomy is a common surgical intervention.

Purpose of the Study:

  • To estimate the degree of injury from laparoscopic cholecystectomy.
  • To determine the neuroendocrine response to surgical aggression in laparoscopic versus open cholecystectomy.

Main Methods:

  • Prospective study with simple randomization.
  • Group A: 17 patients (laparoscopic cholecystectomy).
  • Group B: 18 patients (open surgery).
  • Homogeneous groups regarding age, sex, BMI, duration, and anesthetic drugs.
  • Exclusion criteria: blood derivative transfusion or corticosteroid therapy.

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Main Results:

  • Postoperative increase in plasma ACTH, growth hormone, insulin, cortisol, and T3 in both groups (p < 0.05).
  • Significant postoperative increase in urinary cortisol and catecholamines, particularly in the open surgery group (Group B).

Conclusions:

  • Both laparoscopic and open cholecystectomy induce a contraregulatory hormone increase postoperatively.
  • Laparoscopic cholecystectomy demonstrates a lower overall neuroendocrine response, indicating less surgical aggression.