Original article
Inflammatory reaction assessement in patients after laparoscopic cholecystectomy

Cholelithiasis is one of the most prevalent diseases of the gastrointestinal tract. The present method of treatment of gall stones is the excision of the gall bladder. Laparoscopic cholecystectomy (LC), which started to be applied at the end of the 20-th century, was considered the „gold standard” for the treatment of symptomatic cholelithiasis and started to replace open cholecystectomy (OC). Clinical observations have revealed the advantages of LC: reduced hospital stay, less wound pain, earlier resumption of oral intake, improved cosmetic results and quicker return to full activity. The aim of this study was to compare postoperative inflammatory reaction in patients who underwent LC versus OC. The serum level of IL-1b, IL-10, CRP and C5 was measured before and 1, 3 and 7 day after the surgery using commercially available tests. Data were analysed using t-Student and Wilcoxon tests. 25 women and 5 men underwent LC. OC was performed in 20 women and 7 men. The medium laparoscopic and open cholecystectomy duration was 67 min in the LC group and 78 min in the OC group. There were no surgical complications and all patients had an uncomplicated postoperative course. There were no significant differences in the serum IL-1β levels before and after the surgery in both groups of patients, however the concentrations of IL-1β after LC were higher. The serum IL-10 levels decreased significantly on day 3 and 7 after the surgery in both the LC and OC group. The changes were similar in both groups. The serum CRP levels increased significantly after LC and OC, with peak concentrations on day 3. The CRP levels after OC were higher, but without significant differences. No statistically significant changes of the C5 level occurred at any study time in any group. These observations suggest that the inflammatory response in patients after comparable operation duration and uncomplicated LC and OC may be similar.