Surgical trauma from laparoscopic cholecystectomy

UNLABELLED: The authors present a prospective study whose objective is to estimate the degree of injury from laparoscopic cholecystectomy, by means of the determination of the neuroendocrine response to the surgical aggression. By means of a simple randomization, two study groups are established: group A, consisting of 17 patients subjected to laparoscopic cholecystectomy, and group B, consisting of 18 patients subjected to different techniques of open surgery. EXCLUSION CRITERIA: transfusion of blood derivatives or therapy with corticosteroids. The groups are homogeneous with regard to age, sex, Quetelet index, duration of the intervention, and anaesthetic drugs. A postoperative increase of plasma ACTH, growth hormone, insulin, cortisol and T3 was found in both groups (p < 0.05), and a significant postoperative increase of cortisol and catecholamines in 24 hour urine was found especially in group B. It can be concluded that even though there is an increase of the contraregulatory hormones in the postoperative phase of both groups, the neuroendocrine response is lower after laparoscopic cholecystectomy.