Biohumoral and endocrine parameters in assessment of surgical trauma in open and laparoscopic cholecystectomy

Vojnosanitetski Pregled

关键词: cholecystectomy;    cholecystectomy, laparoscopic;    intraoperative period;    biological markers;    blood chemical analysis;   

DOI  :  10.2298/VSP1306555R

来源: DOAJ

【 摘 要 】

Background/Aim. Every surgical procedure causes metabolic, endocrine, andhemodynamic stress in the organism. The aim of this work was to assess theextent of trauma following each of the two types of cholecystectomy(traditional/open and laparoscopic) by measuring palette of biochemicalparameters. Methods. This prospective, single- center study included 120patients subjected to elective cholecystectomy during the period of one year.Sixty patients were treated laparoscopically and 60 traditionally. Biohumoraland endocrine parameters were determined from 24-hour urine and blood. Wemeasured adrenaline, noradrenaline, metabolites of corticosteroid hormones(17-hydroxyl and 17-keto steroids), C-reactive protein (CRP), albumin,glycemia, creatine-phosphokinase (CPK), lactate-dehydrogenase (LDH), redblood cells sedimentation and serum concentration of potassium. Results. Weobserved significantly lower levels of adrenaline (p < 0.01), noradrenaline(p < 0.05), dopamine (p < 0.01), 17-hydroxyl (p < 0.01) and 17-keto steroids(p < 0.01), glycemia (p < 0.01), CPK (p < 0.01), LDH (p < 0.01) and red bloodcells sedimentation (p < 0.01) following laparoscopic cholecystectomycompared to traditional one. Significant increase in CRP levels was recordedpostoperatively in both groups (p < 0.05), as well as significant decrease inserum albumin values (p < 0.05). Duration of the hospitalization followinglaparoscopic cholecystectomy was significantly shorter (p < 0.01).Conclusion. The intensity of organism response is proportional to theintensity of surgical trauma. Metabolic, tissue and neuroendocrine responseof organism to trauma has lower intensity after laparoscopic cholecystectomy.

【 授权许可】

Unknown