LOW T-3 SYNDROME WITH ASYNCHRONOUS CHANGES OF TT3 AND RT(3) VALUES INLAPAROSCOPIC CHOLECYSTECTOMY

Non-thyroidal illnesses, such as surgical stress, are associated with abnormal metabolism of thyroid hormones. However, the potential impact of variable surgical procedures remain to be elucidated. In order to evaluate the effect of mild surgical stress upon thyroid function, TT4 , TT3, rT3 and TSH were measured in twenty-two patients undergoing lap aroscopic cholecystectomy before (Stage 1), during (Stages 2-5), at th e recovery room (Stage 6) and 24h postoperatively (Stage 7). The value s of TSH remained within the normal limits with transient changes duri ng the study period. Similarly,TT4 values displayed normal variations within the normal range without reaching a statistically significant d ifference during the study period. A decrease of TT3 values was detect ed early at stage 2 during induction of anaesthesia. TT3 remained at l ow levels during the perioperative period, and a further decrease was observed 24 h postoperatively. The above profile of thyroid hormone me tabolism, reflects a low-T3 syndrome in patients undergoing laparoscop ic cholecystectomy. Interestingly, there was a tendency for rT3 to inc rease and it reach its highest value 24h postoperatively with the diff erence being statistically significant (p<0.05). The asynchronous dist ribution of rT3 and TT3 might be attributed to multifactorial influenc es.