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Inflammatory mediators and surgical trauma regarding laparoscopic access: neutrophil function
1Department of Experimental Surgery, University Medical School of Pécs, Hungary.
Acta Chirurgica Hungarica
|January 1, 1997
Summary
Laparoscopic cholecystectomy patients showed normal neutrophil function, unlike open surgery patients who had depleted neutrophils. This suggests differing neutrophil activation contributes to better outcomes in laparoscopic surgery.
Area of Science:
- Immunology
- Surgical Inflammation
Background:
- Polymorphonuclear leukocytes (PMN), or neutrophils, are key inflammatory response cells.
- Surgical procedures like cholecystectomy can significantly impact neutrophil function.
Purpose of the Study:
- To compare neutrophil activation in patients undergoing open cholecystectomy (OC) versus laparoscopic cholecystectomy (LC).
- To evaluate superoxide radical generation and PMN elastase levels post-surgery.
Main Methods:
- Blood samples were collected from 42 patients from admission to day 5 post-surgery.
- Measured superoxide radical generation, lag time, and PMN elastase in isolated PMN.
Main Results:
- Open cholecystectomy (OC) patients exhibited marked depletion in superoxide radical production from day 1 onwards.
- Both groups showed elevated PMN elastase post-surgery, but levels decreased by day 3 in the laparoscopic cholecystectomy (LC) group, while remaining high in the OC group.
- PMN elastase remained elevated longer in OC patients compared to LC patients.
Conclusions:
- Depleted neutrophil functional state in OC patients indicated by reduced free radical production.
- Elevated PMN elastase in OC patients suggests increased harmful potential.
- Differences in neutrophil activation may partly explain the better clinical outcomes observed in LC patients.