Comparison of metabolic responses to laparoscopic and minilaparotomy cholecystectomy.

This randomized study compared the metabolic responses to laparoscopic cholecystectomy (n = 10) and minilaparotomy cholecystectomy with a 5-7-cm incision (n = 10). Venous blood samples were taken before operation and at 3, 6, 9, 12, 18, 24, 48, 72 and 168 h after incision and analysed for levels of C-reactive protein, interleukin 6, cortisol, albumin, transferrin, iron, fibrinogen, fibrin degradation products and polymorphonuclear elastase, and for neutrophil and lymphocyte counts. Urine samples (24 h) were analysed for urea, creatinine, 3-methylhistidine and catecholamines. The magnitude of the metabolic changes from baseline levels was quantified by calculating areas under each individual curve. A significant metabolic response with a similar time course and magnitude of changes occurred after laparoscopic and minilaparotomy cholecystectomy but with wide variation in magnitude between individuals.