Laparoscopic vs Open Cholecystectomy

Jakeways, Msr; Carli, Franco

doi:10.1093/bja/70.5.597

Cited by 7 publications

(2 citation statements)

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“…A considerable number of complications occur only after the patient has been discharged. Jakeways and Carli 38 suggest that the follow-up of patients in randomized trials be continued for several weeks into the postoperative period. Therefore we have attempted to see all patients again 1 and 6 months after surgery reporting five infection of wounds (3 grade I and 2 grade II) only in the open group.…”

Section: Discussionmentioning

confidence: 99%

Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Schietroma

Piccione

Carlei

et al. 2012

The American Surgeon

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Elevated intra-abdominal pressure during laparoscopy may promote systemic inflammatory response. In patients with generalized peritonitis from perforated appendicitis, we sought to compare acute phase response and immunologic status from laparoscopic and open approach. One hundred and forty-seven consecutive patients underwent appendectomy for perforated appendicitis (73 patients had laparoscopic appendectomy and 74 patients had open appendectomy. Bacteremia, endotoxemia, white blood cells, peripheral lymphocytes subpopulation, human leukocyte antigen-DR (HLA-DR), neutrophil-elastase, interleukin-1 and 6 (IL-1 and 6), and C-reactive protein were investigated. One hour after intervention, bacteremia was significantly higher in the open group compared with the laparoscopic group ( P < 0.05). A significantly higher concentration of systemic endotoxin was detected intraoperatively in the open group of patients in comparison with the laparoscopic group ( P < 0.05). Laparotomy caused a significant increase in neutrophil concentration, neutrophil-elastase, IL-1 and 6, and C-reactive protein and a decrease of HLA-DR. We recorded 6 cases (8.1%) of intra-abdominal abscess in the open group and one (1.3%) in the laparoscopic group ( P < 0.05). Open appendectomy, in case of peritonitis, increased the incidence of bacteremia, endotoxemia, and systemic inflammation compared with laparoscopic appendectomy. Early enhanced postoperative systemic inflammation may cause lower transient immunologic defense after laparotomy (decrease of HLA-DR), leading to enhanced sepsis in these patients.

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Section: Discussionmentioning

confidence: 99%

Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Schietroma

Piccione

Carlei

et al. 2012

The American Surgeon

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“…Alternative theories have variously emphasized subclinical mineral de®ciencies 20 , increased brain tryptophan concentrations 21 , disrupted cytokine production 22,23 , disturbed sleep patterns 24,25 and self-ful®lling patient expectations coupled with negative mood 26 as aetiological factors. Clearly, each of these theories carries its own unique implications for potential intervention.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of interventions for postoperative fatigue

Rubin

Hotopf

2002

British Journal of Surgery

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Effects of Laparoscopic and Conventional (Open) Cholecystectomy on Human Leukocyte Antigen‐DR Expression in Peripheral Blood Monocytes: Correlations with Immunologic Status RID="" ID="" This International Society of Surgery (ISS)/Société Internationale de Chirurgie (SIC) article was presented at the 37th World Congress of Surgery International Surgical Week (ISW97), Acapulco, Mexico, August 24–30, 1997.

et al. 1999

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It is well known that surgery significantly decreases immune responses. Laparoscopic cholecystectomy (LC) is a "miniinvasive" surgical procedure; and on the basis of this consideration we have investigated if and how the immune response is modified in patients after laparoscopic cholecystectomy compared to patients who underwent open cholecystectomy. Immune activity [neutrophils, total lymphocytes count, lymphocytes subpopulations, human leukocyte antigen-DR (HLA-DR)] was evaluated in 53 patients 1 day before surgery and respectively, 1, 3, and 6 days after surgery; 26 patients underwent "open" cholecystectomy and 27 LC. A day after surgery, patients with open cholecystectomy showed a significant increase (p < 0.05) in plasma neutrophils, while they were almost unchanged in LC patients. Monocyte antigen HLA-DR was reduced in patients with "open" cholecystectomy. We recorded two cases (7.6%) of respiratory tract infection in the "open" group. In conclusion, LC strongly reduces postoperative (p.o.) pain and hospitalization, and it promotes earlier recovery and return to normal activity, avoiding p.o. immunosuppression, mostly due to conservation of HLA-DR activity, with less p.o. morbidity compared to that seen with open surgery.

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Laparoscopic vs Open Cholecystectomy

Cited by 7 publications

References 0 publications

Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Systematic review and meta-analysis of interventions for postoperative fatigue

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