Cytokines in surgical trauma: cholecystectomy as an example

Interleukin-1 (IL-1), tumor necrosis factor and particularly IL-6 are potent mediators of the immune and acute phase response caused by surgery and trauma. Their production can be reduced by steroids, nonsteroidal anti-inflammatory agents, nitric oxide and anti-inflammatory cytokines such as IL-4, IL-10 and IL-13. Some of the benefits of minimal invasive surgery may be due to lower cytokine levels in these procedures compared to those of conventional surgery, although this is but one factor that should be taken into account. Therefore, all surgical procedures that cause a lower systemic cytokine response are to be favored if other effects and the side effects of the surgery are equal.