Serum interleukin-6 and C reactive protein responses in patients after laparoscopic or conventional cholecystectomy.

OBJECTIVE: To investigate the acute phase inflammatory response to surgical trauma after laparoscopic and conventional cholecystectomy. DESIGN: Prospective open study. SETTING: University Hospital in The Netherlands. SUBJECTS: 21 patients with symptomatic cholelithiasis admitted for elective cholecystectomy who had had no previous upper abdominal operations. INTERVENTIONS: 12 patients underwent conventional, and 9 patients laparoscopic, cholecystectomy. Circulating interleukin-6 (IL-6) and C reactive protein concentrations were measured 6, 12, 24 and 48 hours after operation. MAIN OUTCOME MEASURE: Changes in IL-6 and C reactive protein concentrations, and comparison of operative blood loss and length of stay in hospital. RESULTS: Those treated by laparoscopic cholecystectomy lost significantly less blood (median 60 compared to 100 ml) and spent significantly fewer days in hospital (median 2 compared with 7 days), (p < 0.01 in each case). The only changes in circulating IL-6 concentrations were seen in patients over the age of 60 years who underwent conventional cholecystectomy. There were significant differences in C reactive protein concentrations between the two operations at both 24 and 48 hours after the operation (p < 0.01 in each case). CONCLUSION: We conclude that laparoscopic cholecystectomy reduces the acute phase inflammatory response compared with the conventional operation; there seems to be no relevant correlation between plasma concentrations of IL-6 and C reactive protein; the presence of IL-6 does not affect the response of C reactive protein to trauma; and the response of IL-6 to trauma is age dependent.