Thorell A, Nygren J, Essén P, Gutniak M, Loftenius A, Andersson B, Ljungqvist O
Department of Surgery, Karolinska Hospital & Institute, Stockholm, Sweden.
Eur J Surg. 1996 Mar;162(3):187-91.
To study the changes in insulin sensitivity and plasma concentrations of interleukin-6 (IL-6) after open compared with laparoscopic cholecystectomy.
Prospective open study.
University hospital, Sweden.
12 otherwise healthy patients undergoing either open (n = 6) or laparoscopic (n = 6) cholecystectomy.
Relative insulin sensitivity (compared with preoperative) on the day after operation. Changes in IL-6 concentrations postoperatively.
The mean (SEM) relative reduction in insulin sensitivity was significantly smaller after laparoscopic (18 (5)%) compared with the open operation, (58 (4)%) (p < 0.01). There was a significant increase in plasma concentrations of IL-6 postoperatively, but there was no difference between the groups.
Insulin sensitivity is less affected 24 hours after laparoscopic than after open cholecystectomy, which in this study was not accompanied by a simultaneous difference in the IL-6 response. The small postoperative reduction of insulin sensitivity may be a contributing factor to the clinical benefit of improved wellbeing observed after laparoscopic surgery.
研究开腹胆囊切除术与腹腔镜胆囊切除术后胰岛素敏感性及血浆白细胞介素-6（IL-6）浓度的变化。
前瞻性开放性研究。
瑞典大学医院。
12例身体健康的患者，其中6例行开腹胆囊切除术，6例行腹腔镜胆囊切除术。
术后第1天的相对胰岛素敏感性（与术前相比）。术后IL-6浓度的变化。
与开腹手术相比，腹腔镜手术后胰岛素敏感性的平均（标准误）相对降低幅度明显较小，分别为18（5）%和58（4）%（p<0.01）。术后血浆IL-6浓度显著升高，但两组之间无差异。
腹腔镜胆囊切除术后24小时胰岛素敏感性受影响较开腹手术小，本研究中两组IL-6反应无同时期差异。术后胰岛素敏感性的轻微降低可能是腹腔镜手术后患者幸福感改善这一临床益处的一个促成因素。
