Kohli Ritesh, Bansal Ekta, Gupta Ashwani K, Matreja Prithpal S, Kaur Kulwinder
Ex-Resident, Department of General Surgery, Government Medical College and Rajindra Hospital , Patiala, India .
ID Fellow, Carilion Roanoke Memorial Hospital , Virginia, U.S.A .
J Clin Diagn Res. 2014 Jun;8(6):NC06-8. doi: 10.7860/JCDR/2014/7094.4487. Epub 2014 Jun 20.
The recovery from laparoscopic cholecystectomy (LC) is rapid and most of the patients are discharged on the 1st post-operative day. There is an increased concentration of certain serum proteins, known as acute-phase reactive proteins (APRP) during the post-operative period depends on the degree of tissue damage and the inflammatory reaction. There is a direct positive correlation between the concentrations of APRP, especially C-reactive protein (CRP), and the severity of inflammation. This study was done to study the levels of C - reactive protein and Total Leucocyte Count in patients operated either by Open Cholecystectomy (OC) and Laparoscopic Cholecystectomy (LC).
This prospective study was conducted on 50 patients after approval from the Institutional Ethics Committee. Twenty five patients underwent open cholecystectomy and the other 25 had laparoscopic cholecystectomy. The pre and post operative concentrations of serum C-reactive protein (CRP) and total leukocyte count (TLC) were compared in both the groups.
There were no differences in the preoperative serum CRP and TLC concentrations - in both the groups. Serum CRP rose significantly following OC compared to that of patients who underwent LC (10.52 ± 1.96 mg% vs. 8.88 ± 1.23 mg %). There were also significant differences in the post-operative TLC ( 9.49 ± 1.05 m/mm3 for the OC group vs. 8.57 ± 1.31 m/mm3 for the LC group), and the post-operative hospital stay (5.5 ±1.5 days vs. 1.9 ± 0.9 days). There was no correlation between serum CRP concentrations and the other post-operative parameters.
The study provided the biochemical evidence supporting the clinical observation that LC is far less traumatic to the patient than OC.
腹腔镜胆囊切除术(LC)术后恢复迅速,大多数患者在术后第1天出院。术后期间某些血清蛋白(称为急性期反应蛋白,APRP)的浓度会升高,这取决于组织损伤程度和炎症反应。APRP浓度,尤其是C反应蛋白(CRP)浓度与炎症严重程度呈直接正相关。本研究旨在探讨开腹胆囊切除术(OC)和腹腔镜胆囊切除术(LC)患者的C反应蛋白水平和白细胞总数。
本前瞻性研究经机构伦理委员会批准后,对50例患者进行。25例患者接受开腹胆囊切除术,另外25例接受腹腔镜胆囊切除术。比较两组患者术前和术后血清C反应蛋白(CRP)浓度和白细胞总数(TLC)。
两组患者术前血清CRP和TLC浓度无差异。与接受LC的患者相比,OC术后血清CRP显著升高(10.52±1.96mg%对8.88±1.23mg%)。术后TLC也有显著差异(OC组为9.49±1.05m/mm3,LC组为8.57±1.31m/mm3),术后住院时间也有显著差异(5.5±1.5天对1.9±0.9天)。血清CRP浓度与其他术后参数之间无相关性。
该研究提供了生化证据,支持LC对患者的创伤远小于OC的临床观察。