Schietroma M, Risetti A, Carlei F, Maggi G, Cianca G, De Santis C, Centi D, Iannucci D, Recchia C L, Mattucci S, Simi M
Divisione di Discipline Chirurgiche, Cattedra di Chirurgia Generale II, Università degli Studi, L'Aquila.
Minerva Chir. 1998 May;53(5):359-62.
It is well known that surgery induces an acute inflammatory response associated with significant increase of interleukin-6 (IL-6) and C reactive protein (CRP). Laparoscopic cholecystectomy (LC) is a so called "mini-invasive" surgical intervention and on the basis of this consideration it has been investigated if and how serological markers of inflammation are modified in patients after laparoscopic cholecystectomy compared to patients undergoing open cholecystectomy.
The acute phase of inflammation (IL-6, CRP and body temperature) was evaluated in 53 patients one day before surgery and p.o. after 1, 3 and 6 days; 26 patients underwent "open" cholecystectomy and 27 LC.
One day after surgery patients with open cholecystectomy showed significant increase (p < 0.05) of IL-6, CRP and body temperature, while these parameters were almost unchanged in patients with LC. In patients with "open" cholecystectomy, 2 p.o. complications (pneumonia) were observed.
In conclusion, LC, although it requires longer operative time, strongly reduces p.o. pain, hospitalization, promotes earlier recovery and return to normal activity, avoiding the acute phase of p.o. inflammation with better p.o. morbidity compared to open surgery.
众所周知，手术会引发急性炎症反应，伴有白细胞介素-6（IL-6）和C反应蛋白（CRP）显著升高。腹腔镜胆囊切除术（LC）是一种所谓的“微创”手术干预措施，基于这一考虑，研究了与接受开腹胆囊切除术的患者相比，腹腔镜胆囊切除术后患者炎症的血清学标志物是否以及如何发生改变。
对53例患者在手术前一天以及术后第1、3和6天口服给药后评估炎症急性期（IL-6、CRP和体温）；26例患者接受“开腹”胆囊切除术，27例接受LC。
开腹胆囊切除术后一天，患者的IL-6、CRP和体温显著升高（p < 0.05），而LC患者这些参数几乎未变。在“开腹”胆囊切除术患者中，观察到2例术后并发症（肺炎）。
总之，LC虽然需要更长的手术时间，但能显著减轻术后疼痛、缩短住院时间，促进更早恢复并回归正常活动，与开腹手术相比，避免了术后炎症急性期，术后发病率更低。
