BACKGROUND: Some benefits of laparoscopic (LC) and minilaparotomy (NIC) cholecystectomy may reflect attenuation of the acute phase response. The authors examined components of this response.
METHODS: Patients were randomized to LC (n = 11) or MC (n = II). C-reactive protein (CRP), alpha-1-antitrypsin (AAT), retinol-binding protein (RBP), transferrin, and albumin were measured preoperatively and on postoperative days 1, 2, 4, and 7. Interleukin-1 receptor antagonist (IL-1ra), IL-6, and tumor necrosis factor (TNF-alpha) were measured more frequently perioperatively. Peak expiratory flow rate, forced expiratory volume in 1 second, and forced vital capacity were measured daily.
RESULTS: The IL-6 increase was more persistent and marked in the MC patients from hour 8 to day 7 postoperatively (P < 0.05). Alterations in CRP, AAT, and albumin were similar, Postoperative deficits of respiratory function correlated with the magnitude of acute phase protein alteration.
CONCLUSIONS: Minimal access surgery induces an acute phase response that is less prominent after a laparoscopic technique. (C) 1999 by Excerpta Medica, Inc.
|Number of pages||3|
|Journal||American Journal of Surgery|
|Publication status||Published - 1999|