THE INFLUENCE OF LAPAROSCOPY ON LYMPHOCYTE SUBPOPULATIONS IN THE SURGICAL PATIENT

Background: Surgical stress is known to disturb the immune system so t hat the overall picture is one of generalized immunosuppression propor tional to the degree of stress, It has been suggested that minimally i nvasive procedures, i.e., laparoscopic cholecystectomy, should be acco mpanied by decreased surgical stress. Methods: The present study utili zed a panel of monoclonal antibodies to identify peripheral blood lymp hocyte subpopulations in 11 patients scheduled for elective laparoscop ic cholecystectomy. These were obtained immediately preoperatively, on e day postoperatively, and one week postoperatively. Results: The resu lts demonstrated a significant (p < 0.05) decrease in T-helper to T-su ppressor cell ratios the first day postoperatively compared to the pre operative ratios; the mean decrease was 13% below the preoperative rat ios. There was no significant change in the ratios one week postoperat ively. Conclusions: Even though laparoscopic cholecystectomy has been documented to have less disability and postoperative pain than open ch olecystectomy, alterations in immune function, although attenuated, do persist.