[Transient immunosuppression after abdominal surgical intervention]

Transient immunodepression appears a few hours after surgery and usually regresses spontaneously within 15-20 days. In this study, cellular and humoral immunity parameter values were compared prior to and 24 h, 7 days and 14 days after laparotomic and laparoscopic cholecystectomy (12 patients and 25 patients respectively) operated at the University of Turin's First Surgical Clinic, to look for differences in the immunological effects of these two types of surgery. The following parameters were determined: IgG, IgA, IgM, C3, C4, granulocytes (CD11c), lymphocytes, B lymphocytes (CD19, CD19-CD15), T lymphocytes (CD3), T helper cells (CD3-CD4), T suppressor cells (CD3-CD8), CD4/CD8 ratio, NK cells (CD16), monocytes (CD14, CD11c-CD14), IL-2 receptor expression (CD25), HLA-DR expression (total HLA-DR, HLA-CD3), total cytotoxic activity (CD57), T cell cytotoxic activity (CD8-CD57), and NK cell cytotoxic activity (CD16-CD57). Granulocytes increased significantly (p < 0.05) in both groups. The increase was more marked in the laparotomy group and still evident on the 7th and 14th days. Total T cells, T helpers and NK cells fell after 24 h (p < 0.05) in this group only. These results suggest that laparoscopy is associated with less substantial immunological changes than laparotomy.