Comparisons of Oxidative Stress during Laparoscopic Cholecystectomy and Open Cholecystectomy

Abstract

Purpose: During oxidative stress, the levels of oxygen free radical increase dramatically, which plays a role in apoptosis, aging and is chemic injury, but also leads to positive effects such as induction of host defense genes and mobilization of ion transport systems. It has been suggested that the advantages of laparoscopic surgery are closely related to the reduced oxidative stress that occurs during laparoscopic cholecystectomy (LC) when compared to open cholecystectomy (OC). This study was conducted to compare oxidative stress markers including total antioxidant status (TAS), superoxide dismutase (SOD) and gluthathione reductase (GR) between the LC group and OC group to determine if these surgical procedures result in different patterns of oxidative stress.Methods: Our prospective study included fifty patients with symptomatic cholelithiasis and cholecystitis, of whom 25 underwent LC and 25 underwent OC. The plasma levels of oxidative stress markers (TAS, SOD, and GR) were measured preoperatively and on the 1st, 2nd and 3rd postoperative days.Results: The postoperative hospitalization days differed significantly between the two groups (p＜0.01). The value of TAS decreased in the OC group in the immediate postoperative period (p=0.037), but this difference was not significant when analyzed by ANCOVA (analysis of covariance; p＞0.05). An acceptable postoperative decrease in SOD was observed in the OC group, especially after the 2nd postoperative day (p＜0.01), and this decrease was also significant when analyzed by ANCOVA (p=0.020). GR was decreased in the OC group on