RESPONSE OF SERUM CYTOKINES IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

The clinical observation that a laparoscopic cholecystectomy is a mini mally invasive operation has not been demonstrated on a biochemical ba sis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulat ing protein, correlates with the significance of surgical trauma. Util izing the IL-6 immunoassay, we studied this biochemical parameter of t rauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only laparoscopic cholecystectomy show ed peak IL-6 concentrations of 51 pg/ml (22-86) vs a peak IL-6 concent ration of 124 pg/ml (56-225) for open cholecystectomy. Six additional patients who underwent an ERCP followed by laparoscopic cholecystectom y showed a dramatic rise in peak IL-6 concentration to 315 pg/ml (15-6 34). These results biochemically confirm the true minimal invasiveness of laparoscopic cholecystectomy. The findings in the ERCP-followed-by -laparoscopic-cholecystectomy group support the theory that two invasi ve procedures in close proximity may prime the cytokine system in its response to surgical trauma.