Deuss U, Dietrich J, Kaulen D, Frey K, Spangenberger W, Allolio B, Matuszczak M, Troidl H, Winkelmann W
Department of Internal Medicine II, University of Cologne, Germany.
Endoscopy. 1994 Feb;26(2):235-8. doi: 10.1055/s-2007-1008950.
Laparoscopic cholecystectomy, as a typical example of minimal invasive surgery, is associated with low complication rates and minimal patient discomfort, and provides the same safety as conventional cholecystectomy. In the present prospective observational study, endocrine parameters as indicators for stress response were measured. We investigated 53 patient with laparoscopy cholecystectomy and 12 patients with conventional cholecystectomy. Blood samples were taken pre-, peri-, and postoperatively for measurement of ACTH, cortisol, prolactin, and growth hormone. General anesthesia followed a standardized protocol. The increase in all stress hormones did not differ between patients in the two groups, and was comparable with that reported in the literature and the findings of our own previous studies in patients undergoing conventional cholecystectomy and elective colon resection. We conclude that laparoscopic cholecystectomy is associated with a pronounced endocrine stress response that does not account for the observed differences in the peri- and postoperative complication rate or patient comfort.
腹腔镜胆囊切除术作为微创手术的典型例子，并发症发生率低，患者不适感小，并且与传统胆囊切除术具有相同的安全性。在本前瞻性观察研究中，测量了作为应激反应指标的内分泌参数。我们调查了53例行腹腔镜胆囊切除术的患者和12例行传统胆囊切除术的患者。在术前、术中及术后采集血样，以测量促肾上腺皮质激素、皮质醇、催乳素和生长激素。全身麻醉遵循标准化方案。两组患者所有应激激素的升高情况并无差异，且与文献报道以及我们之前对行传统胆囊切除术和择期结肠切除术患者的研究结果相当。我们得出结论，腹腔镜胆囊切除术会引发明显的内分泌应激反应，但这并不能解释观察到的围手术期和术后并发症发生率或患者舒适度的差异。
