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Cited 34 time in webofscience Cited 37 time in scopus
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Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis: A prospective randomized study

Authors
Boo, Y. -J.Kim, W. -B.Kim, J.Song, T. -J.Choi, S. -Y.Kim, Y. -C.Suh, S. -O.
Issue Date
2007
Publisher
TAYLOR & FRANCIS LTD
Keywords
acute cholecystitis; immunosuppression; laparoscopic cholecystectomy; TNF-alpha
Citation
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, v.67, no.2, pp.207 - 214
Indexed
SCIE
SCOPUS
Journal Title
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION
Volume
67
Number
2
Start Page
207
End Page
214
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/18422
DOI
10.1080/00365510601011585
ISSN
0036-5513
Abstract
Objective. Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of this study is to evaluate the influence of surgical trauma on systemic inflammation and the immune response in acute cholecystitis. Material and methods. Thirty-three patients with acute calculous cholecystitis were assigned to laparoscopic cholecystectomy (LC, n=18) or open cholecystectomy (OC, n=15). Blood samples were obtained preoperatively and on postoperative day 1 (24 h after surgery) and day 3 (72 h after surgery), and blood concentration of C-reactive protein (CRP), leukocyte subpopulations, as well as levels of tumor necrosis factor-alpha (TNF-alpha) ex vivo secretion by peripheral blood mononuclear cells (PBMCs) were measured in both groups. Results. Hospitalization was significantly shorter in the LC group than in the OC group (LC group: 3.7 +/- 1.2 days versus OC group: 6.3 +/- 2.7 days, p=0.010). There was no postoperative morbidity in the LC group, but two patients in the OC group had postoperative complications. Postoperative TNF-alpha, ex vivo secretion by PBMCs and PBMC counts in the OC group were significantly lower than those in the LC group (p=0.002). The CRP level declined by postoperative day 3, but was significantly less in the OC group than in the LC group (p < 0.001). Postoperative monocyte counts significantly decreased in the OC group compared with those in the LC group (p = 0.001). Conclusions. A laparoscopic approach appears to cause less surgical trauma and immunosuppression than open surgery in patients with acute cholecystitis.
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2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
2. Clinical Science > Department of Pediatric Surgery > 1. Journal Articles

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Song, Taejin
Ansan Hospital (Department of Hepato-Biliary-Pancreatic Surgery, Ansan Hospital)
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