Unimpaired immune functions after laparoscopic cholecystectomy

Area of Science:

• Surgical Innovation
• Immunology
• Gastroenterology

Background:

• Laparoscopic cholecystectomy is associated with less surgical trauma compared to open procedures.
• The impact of laparoscopic cholecystectomy on postoperative immune suppression remains unclear.

Purpose of the Study:

• To evaluate and compare the perioperative cellular immunocompetence in patients undergoing laparoscopic versus open cholecystectomy.
• To determine if reduced surgical trauma in laparoscopic procedures translates to preserved immune function.

Main Methods:

• Assessed perioperative cellular immunocompetence in 8 laparoscopic and 8 open cholecystectomy patients.
• Measured inflammatory markers (white blood cell count, serum interleukin-6) and immune responses (phytohemagglutinin skin testing, mononuclear cell phenotyping).
• Evaluations were conducted pre-operation, 24 hours post-operation, and 6 days post-operation.

Main Results:

• Laparoscopic cholecystectomy did not elevate acute inflammation markers (granulocytes, interleukin-6) at 24 hours.
• Open cholecystectomy significantly reduced phytohemagglutinin responsiveness (67% reduction) and HLA-DR expression on monocytes, unlike laparoscopic surgery (0% reduction).
• Immune parameters returned to baseline within 6 days for both groups.

Conclusions:

• Laparoscopic cholecystectomy does not significantly impair cellular immune functions compared to open cholecystectomy.
• Preservation of immunocompetence provides an additional clinical benefit favoring the laparoscopic approach.
• Minimally invasive surgery maintains immune integrity, supporting its preference in cholecystectomy procedures.