Operative stress response and energy metabolism after laparoscopic cholecystectomy compared to open surgery

Luo, Kai; Li, Jieshou; Li, Ling-Tang; Wang, Kei-Hui; Shun, Jing-Mei

doi:10.3748/wjg.v9.i4.847

Cited by 45 publications

(31 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6,7 In different previous studies it has been clearly demonstrated that the level of serum cortisol elevates significantly after open cholecystectomy as compared to laparoscopic cholecystectomy from postoperative day one up to day three. 8,9 In the present study, marked increase in the serum cortisol level was found after open cholecystectomy. The rise of serum cortisol was momentous in the open group at 6 hours after the operation as compared to the laparoscopic group.…”

Section: Discussionsupporting

confidence: 61%

Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

Kothari¹,

Rao²

2017

Int Surg J

View full text Add to dashboard Cite

Background: Surgical trauma by incision and dissection of tissue stimulates the body to respond proportionately to the extent of injury. This study was conducted with an aim to compare metabolic and inflammatory responses after laparoscopic and open cholecystectomy namely serum cortisol and C-reactive protein levels before and after operation at Bhuj, Kutch, India.Methods: Present study was non-randomized, and comparative study carry out in the General Surgery Department at Gujarat Adani prospective institute of Medical Science, Bhuj, Kutch, Gujarat, India for an era of two years. One hundred and two patients were included in this study and were divided into two groups of open and laparoscopic cholecystectomy. Out of these 102 patients, 41 undergo open cholecystectomy and 61 laparoscopic cholecystectomy. Preoperative, intraoperative, postoperative and anesthetic medications were consistent in all the patients.Results: It was found that metabolic responses like serum cortisol were significantly higher after open procedure 6 hours and 48 hours postoperatively. Similarly, inflammatory response indicator C-reactive protein was raised significantly higher 48 hours after open as compared to laparoscopic cholecystectomy.Conclusions: Open cholecystectomy caused further tissue responses as compared to its laparoscopic alternative.

show abstract

Section: Discussionsupporting

confidence: 61%

Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

Kothari¹,

Rao²

2017

Int Surg J

View full text Add to dashboard Cite

show abstract

“…Reduced adrenaline and noradrenaline values after laparoscopic cholecystectomy were reported in earlier studies and this is consistent with our controlled study. 6,15,23,26,29 On the other hand, when examining the HPA axis, the majority of earlier studies reported great differences in cortisol levels between laparoscopic and open cholecystectomies, 8,9,15,26,29,30 while a few showed no such differences. 7,17 Our well controlled study confirms the results of the latter and our explanation for this is that the stress of the small surgical incision is not greater that the stress of the laparoscopy incisions, the pneumoperitoneum, etc.…”

Section: Discussionmentioning

confidence: 97%

“…We used large male pigs weighing about [25][26][27][28][29][30] Kg, crossbreeds of the Landrace and Large White strains. Eight of these underwent cholecystectomy, three (n=3) open and the rest (n=5) laparoscopic cholecystectomy.…”

Section: Animalsmentioning

confidence: 99%

Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Krikri¹,

Alexopoulos²,

Zoumakis³

et al. 2013

View full text Add to dashboard Cite

ObJEcTIVE: Minimally invasive operations, such as laparoscopic cholecystectomy and adrenalectomy, result in a more rapid recovery of normal function, less physiological disturbances and less stress to the organism than similar open operations. The purpose of this study was to determine the stress response associated with minimally invasive abdominal surgery compared to conventional small or large incision laparotomy. METHODs: We compared the responses of the stress hormones cortisol and the catecholamines adrenaline and noradrenaline to elective conventional and laparoscopic cholecystectomy and unilateral adrenalectomy in male pigs. blood samples were taken from all animals at the same time, one day before surgery, at the beginning of the operation, every 15 minutes during surgery and on the first postoperative morning. rEsULTs: Plasma adrenaline and noradrenaline concentrations were significantly lower in both cholecystectomies (p<0.05) and adrenalectomies (p<0.01) during laparoscopic than during open surgery. Plasma cortisol levels were significantly lower in laparoscopic than in open adrenalectomies both during surgery and on postoperative day one (p<0.05), while no major differences in cortisol levels were observed between laparoscopic and open cholecystectomies. Thus, the stress-related benefit of laparoscopic surgery depended on the size of the surgical incision in the conventional operation. cONcLUsION: Laparoscopic surgery was associated with less surgical stress than open surgery and this difference was accentuated as the surgical abdominal wall trauma increased.

show abstract

“…Koivusalo et al (35) reported that pneumoperitoneum was not associated with an additional risk in ASA III and ASA IV elderly patients during LC. Luo et al (36) concluded that LC is beneficial for restoration of stress hormones, nitrogen balance, and energy metabolism but that it may also cause acidemia and pulmonary hypoperfusion due to pneumoperitoneum. In our study, ASA scores were significantly different between the groups, the LPC group consisted of higher risk patients.…”

mentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

View full text Add to dashboard Cite

Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

show abstract

Operative stress response and energy metabolism after laparoscopic cholecystectomy compared to open surgery

Cited by 45 publications

References 27 publications

Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Contact Info

Product

Resources

About