THE EFFECT OF LAPAROSCOPIC CHOLECYSTECTOMY ON INSULIN SENSITIVITY

It is well known that there is impaired glucose tolerance after open a bdominal surgery. We have investigated the effect on insulin sensitivi ty of laparoscopic cholecystectomy. Eight non-diabetic patients aged 5 1+/-3.5 years were studied pre and postoperatively. Insulin sensitivit y measured by the short insulin tolerance test (ITT) was expressed as % disappearance of glucose per minute (K-ITT). Preoperative fasting bl ood glucose was 4.7+/-0.15 mmol/l compared with postoperative fasting blood glucose of 5.7+/-0.31 mmol/l (p = 0.02). Fasting insulin levels were 8.4+/-1.6 mU/l preoperatively compared to 30.0+/-9.3 mU/l postope ratively (p = 0.1 NS). K-ITT was 2.29+/-0.2% min(-1) (range 1.0-3.03) preoperatively with 1.11+/-0.25% min(-1) (range 0.13-1.97) postoperati vely (p = 0.02). Hence marked insulin resistance is a consequence of m ajor abdominal surgery irrespective of surgical technique.