Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle

P Essen, A Thorell, M A McNurlan, Susan Elizabeth Anderson, O Ljungqvist, J Wernerman, P J Garlick

Research output: Contribution to journalArticle

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Abstract

Objective The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.

Summary Background Data Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.

Methods Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(H-2,)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.

Results The protein synthesis rate decreased by 28% (1.77 +/- 0.11%/day vs. 1.26 +/- 0.08%/day, p < 0.01) in the laparoscopic group and by 20% (1.97 +/- 0.15%/day vs. 1.57 +/- 0.15%/day, p < 0.01) in the open cholecystectomy group. In contrast, the fail in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2%) compared with open surgery (49 +/- 5%).

Conclusions Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.

Original languageEnglish
Pages (from-to)36-42
Number of pages7
JournalAnnals of Surgery
Volume222
Issue number1
Publication statusPublished - Jul 1995

Keywords

  • UPPER ABDOMINAL-SURGERY
  • PLASMA-CATECHOLAMINES
  • SKELETAL-MUSCLE
  • INTERLEUKIN-6
  • OPERATION
  • STRESS
  • GLUCONEOGENESIS
  • METABOLISM
  • ANESTHESIA
  • NUTRITION

Cite this

Essen, P., Thorell, A., McNurlan, M. A., Anderson, S. E., Ljungqvist, O., Wernerman, J., & Garlick, P. J. (1995). Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle. Annals of Surgery, 222(1), 36-42.

Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle. / Essen, P ; Thorell, A ; McNurlan, M A ; Anderson, Susan Elizabeth; Ljungqvist, O ; Wernerman, J ; Garlick, P J .

In: Annals of Surgery, Vol. 222, No. 1, 07.1995, p. 36-42.

Research output: Contribution to journalArticle

Essen, P, Thorell, A, McNurlan, MA, Anderson, SE, Ljungqvist, O, Wernerman, J & Garlick, PJ 1995, 'Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle', Annals of Surgery, vol. 222, no. 1, pp. 36-42.
Essen P, Thorell A, McNurlan MA, Anderson SE, Ljungqvist O, Wernerman J et al. Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle. Annals of Surgery. 1995 Jul;222(1):36-42.
Essen, P ; Thorell, A ; McNurlan, M A ; Anderson, Susan Elizabeth ; Ljungqvist, O ; Wernerman, J ; Garlick, P J . / Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle. In: Annals of Surgery. 1995 ; Vol. 222, No. 1. pp. 36-42.
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title = "Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle",
abstract = "Objective The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.Summary Background Data Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.Methods Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(H-2,)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.Results The protein synthesis rate decreased by 28{\%} (1.77 +/- 0.11{\%}/day vs. 1.26 +/- 0.08{\%}/day, p < 0.01) in the laparoscopic group and by 20{\%} (1.97 +/- 0.15{\%}/day vs. 1.57 +/- 0.15{\%}/day, p < 0.01) in the open cholecystectomy group. In contrast, the fail in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2{\%}) compared with open surgery (49 +/- 5{\%}).Conclusions Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.",
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T1 - Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle

AU - Essen, P

AU - Thorell, A

AU - McNurlan, M A

AU - Anderson, Susan Elizabeth

AU - Ljungqvist, O

AU - Wernerman, J

AU - Garlick, P J

PY - 1995/7

Y1 - 1995/7

N2 - Objective The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.Summary Background Data Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.Methods Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(H-2,)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.Results The protein synthesis rate decreased by 28% (1.77 +/- 0.11%/day vs. 1.26 +/- 0.08%/day, p < 0.01) in the laparoscopic group and by 20% (1.97 +/- 0.15%/day vs. 1.57 +/- 0.15%/day, p < 0.01) in the open cholecystectomy group. In contrast, the fail in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2%) compared with open surgery (49 +/- 5%).Conclusions Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.

AB - Objective The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.Summary Background Data Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.Methods Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(H-2,)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.Results The protein synthesis rate decreased by 28% (1.77 +/- 0.11%/day vs. 1.26 +/- 0.08%/day, p < 0.01) in the laparoscopic group and by 20% (1.97 +/- 0.15%/day vs. 1.57 +/- 0.15%/day, p < 0.01) in the open cholecystectomy group. In contrast, the fail in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2%) compared with open surgery (49 +/- 5%).Conclusions Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.

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KW - SKELETAL-MUSCLE

KW - INTERLEUKIN-6

KW - OPERATION

KW - STRESS

KW - GLUCONEOGENESIS

KW - METABOLISM

KW - ANESTHESIA

KW - NUTRITION

M3 - Article

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SP - 36

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JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

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ER -