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[Response of interleukin-6 in patients undergoing a laparoscopic or laparotomic cholecystectomy]
M Schietroma1, A Risetti, F Carlei
1Divisione di Discipline Chirurgiche, Cattedra di Chirurgia Generale II, Università degli Studi, L'Aquila.
Insights
Laparoscopic cholecystectomy (LC) significantly reduces post-operative inflammation, pain, and complications compared to open surgery. This minimally invasive approach leads to faster recovery and a shorter hospital stay for patients.
Area of Science:
- Surgical inflammation markers
- Minimally invasive surgery outcomes
- Postoperative recovery metrics
Context:
- Surgery triggers an acute inflammatory response, marked by increased interleukin-6 (IL-6) and C-reactive protein (CRP).
- Laparoscopic cholecystectomy (LC) is considered a minimally invasive procedure.
- This study compares inflammatory markers after LC versus open cholecystectomy.
Purpose:
- To investigate and compare serological markers of inflammation (IL-6, CRP, body temperature) in patients undergoing LC versus open cholecystectomy.
- To evaluate the impact of surgical approach on postoperative complications and recovery.
Summary:
- Postoperative evaluation of IL-6, CRP, and body temperature was conducted on 53 patients (26 open, 27 LC) at baseline and on days 1, 3, and 6.
- Open cholecystectomy patients exhibited a significant increase in inflammatory markers and body temperature one day post-surgery.
- LC patients showed minimal changes in these parameters, with no observed complications like pneumonia.
Impact:
- Laparoscopic cholecystectomy significantly mitigates the acute postoperative inflammatory phase.
- LC leads to reduced pain, shorter hospitalization, and earlier return to normal activities compared to open surgery.
- The findings suggest LC offers better postoperative morbidity outcomes.
Background:
It is well known that surgery induces an acute inflammatory response associated with significant increase of interleukin-6 (IL-6) and C reactive protein (CRP). Laparoscopic cholecystectomy (LC) is a so called "mini-invasive" surgical intervention and on the basis of this consideration it has been investigated if and how serological markers of inflammation are modified in patients after laparoscopic cholecystectomy compared to patients undergoing open cholecystectomy.
Methods:
The acute phase of inflammation (IL-6, CRP and body temperature) was evaluated in 53 patients one day before surgery and p.o. after 1, 3 and 6 days; 26 patients underwent "open" cholecystectomy and 27 LC.
Results:
One day after surgery patients with open cholecystectomy showed significant increase (p < 0.05) of IL-6, CRP and body temperature, while these parameters were almost unchanged in patients with LC. In patients with "open" cholecystectomy, 2 p.o. complications (pneumonia) were observed.
Conclusions:
In conclusion, LC, although it requires longer operative time, strongly reduces p.o. pain, hospitalization, promotes earlier recovery and return to normal activity, avoiding the acute phase of p.o. inflammation with better p.o. morbidity compared to open surgery.