Inflammatory mediators and surgical trauma regarding laparoscopic access: acute phase response.

Numerous studies have tried to compare different aspects of patient response to laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC). Our study focused on the acute phase response in order to clarify the better patient recovery following LC. Sixteen patients scheduled for elective cholecystectomy were equally allocated into groups of OC and LC. Blood samples were collected before and for four days after the procedures. Levels of interleukin 6 (IL-6) and C-reactive protein (CRP) were determined by ELISA technique. IL-6 value increased ten fold on the first postoperative day (52.8 pg/ml) in the OC group with a return to baseline value by the fourth postoperative day. In contrast a moderate increase postoperatively (12.1 pg/ml) with a fast normalisation of IL-6 value by the second postoperative day was noted in LC group. A similar pattern was observed in the CRP level. CRP peaked to 84.1 mg/l by the second follow-up day after OC, while only an insignificant rise to 52.7 mg/l was registered in the LC group with again a faster return to baseline value. The marked contrast between the two groups with regard to IL-6 and CRP changes clearly underlines a diminished acute phase response following LC, which verifies LC as probably a less traumatic procedure.