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How minimally invasive is laparoscopic cholecystectomy?
A O Aktan1, O Büyükgebiz, C Yeğen
1Marmara University School of Medicine, Department of General Surgery, Istanbul, Turkey.
Surgical Laparoscopy & Endoscopy
|February 1, 1994
Summary
Open cholecystectomy causes more surgical stress than laparoscopic surgery, evidenced by higher hormone levels. Both procedures show similar hormonal recovery, suggesting laparoscopy is minimally invasive.
Area of Science:
- Endocrinology
- Surgical Stress Response
- Minimally Invasive Surgery
Background:
- Cholecystectomy is a common surgical procedure.
- Assessing surgical stress is crucial for patient recovery.
- Hormonal responses can indicate the severity of surgical stress.
Purpose of the Study:
- To compare the surgical stress induced by open versus laparoscopic cholecystectomy.
- To evaluate postoperative serum hormone levels (cortisol, growth hormone, insulin) in both surgical groups.
Main Methods:
- A comparative study involving 20 patients undergoing open cholecystectomy and 20 undergoing laparoscopic cholecystectomy.
- Measurement of serum cortisol, growth hormone, and insulin levels at various postoperative time points (8, 24, and 48 hours).
Main Results:
- Open cholecystectomy group showed significant elevations in cortisol, growth hormone, and insulin 8 hours post-surgery.
- Laparoscopic cholecystectomy group had a significant increase only in growth hormone.
- Insulin levels remained elevated in both groups 24 and 48 hours post-surgery.
- Cortisol and growth hormone returned to baseline in both groups by 48 hours.
Conclusions:
- Open cholecystectomy induces a more severe acute surgical stress response compared to laparoscopic cholecystectomy.
- Laparoscopic cholecystectomy demonstrates a 'minimally invasive' profile regarding hormonal stress response.
- Hormonal convalescence rates were comparable between the two surgical approaches.