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Systemic stress response after laparoscopic or open cholecystectomy: a randomized trial
A J Karayiannakis1, G G Makri, A Mantzioka
1Second Propaedeutic Department of Surgery, University of Athens Medical School, Greece.
The British Journal of Surgery
|April 1, 1997
Summary
Laparoscopic cholecystectomy results in a significantly reduced neuroendocrine and metabolic stress response compared to open cholecystectomy. This indicates less surgical injury with the laparoscopic approach.
Area of Science:
- Surgical Endocrinology
- Metabolic Stress Response
- Inflammatory Markers
Background:
- Surgical injury triggers a systemic endocrine-metabolic response proportional to stress severity.
- Laparoscopic cholecystectomy shows favorable outcomes, suggesting reduced surgical injury compared to open procedures.
Purpose of the Study:
- To compare the neuroendocrine and metabolic stress responses between laparoscopic and open cholecystectomy.
- To evaluate the impact of surgical approach on stress markers and inflammation.
Main Methods:
- A randomized clinical trial involving 41 laparoscopic and 42 open cholecystectomy patients.
- Measurement of plasma cortisol, catecholamines, glucose, IL-6, and CRP pre- and post-operatively.
Main Results:
- Open cholecystectomy led to significantly higher postoperative levels of cortisol, catecholamines, glucose, IL-6, and CRP (P < 0.05).
- Neuroendocrine and inflammatory responses were elevated in both groups but markedly greater after open surgery.
Conclusions:
- Laparoscopic cholecystectomy demonstrates a significantly reduced neuroendocrine stress response compared to open cholecystectomy.
- The inflammatory response is also significantly lower following laparoscopic cholecystectomy.