THE SYSTEMIC RESPONSE TO TRAUMA OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY (PROSPECTIVE CLINICAL STUDY)
GÖKHAN ADAŞ, ÖZGÜR ODABAŞ, KEMAL DOLAY, ALİ ÇINAR, SEFATÜZÜN, BAKİ KUMBASAR
Haseki Hastanesi 2. Cerrahi Servisi, İSTANBUL
The basic aim of the organism against trauma is to produce a response to protect homeostasis. The neuroendocrine response to trauma, mediator release, intra and intercellular metabolic changes varies according to type and duration of the trauma. The aim of our study is to compare laparoscopic cholecystectomy with open cholecystectomy in terms of neuroendocrine response, ventilation mechanics and heart rhytm disturbances. Randomly selected 40 patients with symptomatic gallstones were evaluated prospectively. The patients were divided into two equal groups. Open technique was performed in the first group (n=20) and laparoscopic cholecystectomy was performed in the first group (n=20) and laparoscopic cholecystectomy was performed in the second group (n=20). VC, FVC, FEV1 values were found significant (p<0.05) at early and late periods in laparoscopic cholecystectomy group. p was significant in noradrenaline values but insignificant in ADH values at early and late periods (p>0.05), p was insignificant (p>0.05) at early period in renin values but was significant (p<0.05) at late period, CRP values were significant (p<0.05); pO2 and pCO2 values were insignificant (p>0.05). The amount of bleeding was significantly lower in laparoscopic cholecystectomy group (p<0.05). There was no significant difference in body temperature and cardiac aspect between the groups and were excluded from the statistical analysis. As a result we observe that laparoscopic cholecystectomy provides minimal trauma and better patient comfort.
Keywords: LAPAROSCOPIC CHOLECYSTECTOMY, TRAUMA, NEUROENDOCRINE RESPONSE