IS LAPAROSCOPIC CHOLECYSTECTOMY TRULY MINIMAL INVASIVE?

Abstract

To determine the extent of surgical stress induced by open (n=20) and laparoscopic cholecystectomy (n=20), postoperative serum cortizol, growth hormone, and insulin responses were determined in each group. The groups were similar regarding age, sex distrubition and the duration of the surgical procedures.

The open cholecystectomy group revealed significant elevations of serum cortisol, growth hormone, and insulin levels eight hours after surgery (p<0.05). The increased cortisol and growth hormone levels returned back to preoperative control levels 48 hours after surgery. In the laparocopically operated group while all the hormones increased after surgery, only the increase of growth hormone was statistically significant (p<0.05). The serum cortisol and growth hormone levels gradually returned back to control values 48 hours after surgery. The increased serum insulin levels persisted to be significantly high in both groups 24 and 48 hours after surgery (p<0.05). It is concluded that, acute surgical stress induced by open cholecystectomy is more severe than laparoscopic surgery as reflected by serum hormone determinations. However, the hormonal convalescence rate was similiar for both groups. It appears that laparoscopic cholecystectomy is "minimally invasive" as far as the hormonal responses are corcerned.