SYSTEMIC INFLAMMATORY RESPONSE TO OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

The aim of this study is to research systemic inflammatory response of the human body to laparoscopic and open cholecystectomy. Laparoscopic cholecystectomy gained wide acceptance in the treatment of cholelithiasis because of its less traumatic status. The intensity of surgical trauma can be evaluated objectively with the measurements of metabolic and hormonal responses of the human body to the surgery. This ctinical study was carried on 40 patients with uncomplicated symptomatic gallbladder stones. Open cholecystectomy was performed on 20 patients and laparoscopic cholecystectomy on the other 20 patients. Inflammatory response to surgical injury was evaluated with serum interleukin-6 (IL-6) and serum C-reactive protein (CRP) levels. There was no significant age and sex differences between the two groups, Mean operative time was 75 ( 17.4 minutes in open and 87 ( 25.2 minutes in laparoscopic cholecystectomy (p=0.07). Mean serum IL-6 levels at twelfth hours after the beginning of the operation were 34.3 ( 18.2 in laparoscopic and 149.6 ± 104.5 pg/ml in open cholecystectomy groups (p=0.0000038). Mean serum CRP levels at fourty-eight hour postoperatively were 55.6 ( 43.5 in laparoscopic and 161.2 ± 79 mg/L in open cholecystectomy groups (p=0.00026). Inconclusion, systemic inflammatory response to surgical injury was significantly less in laparoscopic than open cholecystectomy. Therefore, laparoscopic cholecystectomy with significantly less surgical stress, is the first choice in the treatment of gallbladder stones.