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[General stress response in laparoscopic and conventional cholecystectomy]
F Glaser1, C Kuntz, G A Sannwald
1Chirurgische Universitätsklinik, Heidelberg.
Swiss Surgery = Schweizer Chirurgie = Chirurgie Suisse = Chirurgia Svizzera
|January 1, 1996
Summary
Laparoscopic cholecystectomy (LCE) results in a significantly lower stress response compared to conventional cholecystectomy (CCE). This is evidenced by lower levels of inflammatory markers and stress hormones in patients undergoing LCE for gallstones.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Surgical Stress Response
Background:
- Cholelithiasis (gallstones) often necessitates surgical intervention.
- Conventional cholecystectomy (CCE) is a standard treatment but can induce significant physiological stress.
- Laparoscopic cholecystectomy (LCE) offers a minimally invasive alternative.
Purpose of the Study:
- To objectively compare the perioperative stress response between LCE and CCE.
- To quantify biochemical markers of stress in patients undergoing elective cholecystectomy.
Main Methods:
- A prospective, controlled trial comparing LCE and CCE.
- Measurement of biochemical stress parameters (interleukin 1 beta, interleukin 6, epinephrine, norepinephrine, glucose) in blood samples.
- Exclusion of patients with acute cholecystitis, pancreatitis, choledocholithiasis, or malignancy.
Main Results:
- Forty patients underwent LCE, and 18 patients underwent CCE.
- Both groups exhibited similar patient characteristics and perioperative care.
- The LCE group demonstrated a significantly lower stress response, indicated by reduced levels of interleukin 1 beta, interleukin 6, epinephrine, norepinephrine, and glucose.
Conclusions:
- Laparoscopic cholecystectomy elicits a demonstrably lower perioperative stress response than conventional cholecystectomy.
- Minimally invasive approaches like LCE may offer advantages in mitigating surgical stress.
- Biochemical markers provide objective measures for evaluating surgical stress.