Laparoscopic surgery and Kupffer cell activation

Background: Evidence tends to support a relative preservation of the system ic immune response with laparoscopy as compared with laparotomy. However, t he role of hepatic macrophages, or Kupffer cells, in modulating this immune advantage is unknown. This study investigated the functions of Kupffer cel ls after either laparoscopy or laparotomy in a rat model. Methods: Rats underwent laparoscopy, laparotomy, or control operations. Kup ffer cells were harvested, cultured, and stimulated with lipopolysaccharide . Culture supernatants were analyzed for tumor necrosis factor (TNF-alpha) and interleukin-6 (IL-6). Cytoplasmic lysates were analyzed for activation of two mitogen-activated protein kinases (MAPKs). Results: Production of TNF-alpha and IL-6 was similar in laparoscopy, lapar otomy, and control groups. Both laparotomy and laparoscopy showed increased activation of p38 MAPK as compared with controls. Activation of ERK1/2 was decreased during laparotomy as compared with laparoscopy. Conclusions: Although cytokine production was similar in the laparoscopy an d laparotomy groups, changes in MAPK activation suggest that intracellular pathways are more affected during laparotomy than during laparoscopy.