Document 0647
 DOCN  M9550647
 TI    Effects of surgical trauma of laparoscopic vs. open cholecystectomy.
 DT    9505
 AU    Dionigi R; Dominioni L; Benevento A; Giudice G; Cuffari S; Bordone N;
       Caravati F; Carcano G; Gennari R; Department of Surgery, Clinica
       Chirurgica, University of Pavia,; Italy.
 SO    Hepatogastroenterology. 1994 Oct;41(5):471-6. Unique Identifier :
       AIDSLINE MED/95154790
 AB    The effects of surgical trauma resulting from laparoscopic
       cholecystectomy and open cholecystectomy, were compared by assessing the
       postoperative acute phase alterations of selected plasma proteins,
       hormones and lymphocyte subpopulations in fifty-seven patients prior to
       elective cholecystectomy. Patients were prospectively randomized to
       undergo either laparoscopic cholecystectomy (n = 30) or open
       cholecystectomy (n = 27). Duration of operation and general anesthesia
       was similar in the two patient groups. The laparoscopic cholecystectomy
       patients had a shorter postoperative stay in hospital (3.1 (0.5) days
       vs. 7.1 (1.6) days; p < 0.001). In open cholecystectomy patients a
       significantly greater postoperative acute phase increase in plasma
       C-reactive protein (p < 0.001), cortisol (p < 0.05), and prolactin blood
       level (p < 0.001) was recorded. The postoperative acute phase decrease
       in the blood total-T-lymphocyte count (CD3 cells) and in the
       activated-lymphocyte count (OKDR cells) was significantly greater after
       open cholecystectomy (p < 0.05). These results, showing that acute phase
       responses are less marked after laparoscopic cholecystectomy than after
       open cholecystectomy, support the concept that the laparoscopic
       procedure is less traumatic.
 DE    Acute-Phase Reaction/*BLOOD  Adult  Biological Markers/BLOOD  C-Reactive
       Protein/*ANALYSIS  *Cholecystectomy  Cholecystectomy, Laparoscopic
       Cholelithiasis/*SURGERY  Comparative Study  CD4-Positive
       T-Lymphocytes/METABOLISM  CD8-Positive T-Lymphocytes/METABOLISM  Female
       Human  Hydrocortisone/*BLOOD  Length of Stay  Lymphocyte Count
       Lymphocyte Transformation  Male  Middle Age  Orosomucoid/*ANALYSIS
       Preoperative Care  Prolactin/*BLOOD  Prospective Studies  Support,
       Non-U.S. Gov't  T-Lymphocyte Subsets/*METABOLISM
       T-Lymphocytes/*METABOLISM  Treatment Outcome  CLINICAL TRIAL  JOURNAL
       ARTICLE  RANDOMIZED CONTROLLED TRIAL

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