Skip to main content
Log in

Response of serum cytokines in patients undergoing laparoscopic cholecystectomy

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

The clinical observation that a laparoscopic cholecystectomy is a minimally invasive operation has not been demonstrated on a biochemical basis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulating protein, correlates with the significance of surgical trauma. Utilizing the IL-6 immunoassay, we studied this biochemical parameter of trauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only laparoscopic cholecystectomy showed peak IL-6 concentrations of 51 pg/ml (22–86) vs a peak IL-6 concentration of 124 pg/ml (56–225) for open cholecystectomy. Six additional patients who underwent an ERCP followed by laparoscopic cholecystectomy showed a dramatic rise in peak IL-6 concentration to 315 pg/ml (15–634). 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 invasive procedures in close proximity may prime the cytokine system in its response to surgical trauma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cruickshank AM, Frazer WD, Burns HJG, Van Damme J, Shenkin A (1990) Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci 79: 161–165.

    CAS  Google Scholar 

  2. Fong Y, Moldawer LL, Shires T, Lowry SF (1990) The biological characteristics of cytokines and their implication in surgical injury. Surg Gynecol Obstet 170: 363–378

    Google Scholar 

  3. Fraser WD, Taggart DP, Fell GS, et al. (1989) Changes in iron, zinc, and copper concentrations in serum and in their binding to transport proteins after cholecystectomy and cardiac surgery. Clin Chem 35:2243–2247

    Google Scholar 

  4. Gauldie J, Northemann W, Fey GH (1990) IL-6 functions as an exocrine hormone in inflammation. J Immunol 144:3804–3808

    Google Scholar 

  5. Gauldie J, Richards C, Harnish D, Lansdorp P, Baumann H (1987) Interferon beta2/B cell stimulatory factor type 2 shares identity with monocyte-derived hepatocyte-stimulating factor and regulates the major acute phase protein response in liver cells. Proc Natl Acad Sci USA 84:7252–7256

    Google Scholar 

  6. Hirano T, Akira S, Taga T, Kishimoto T (1990) Biological and clinical aspects of interleukin 6. Immunol Today 11: 443–449

    Google Scholar 

  7. Houssiau FA, Coulie PG, Van Snick J (1989) Distinct roles of Il-1 and Il-6 in human T-cell activation. J Immunol 143:2520–2524

    Google Scholar 

  8. Le J, Vilcek J (1989) Biology of disease interleukin 6: a multifunctional cytokine regulating immune reactions and the acute phase protein response. Lab Invest 61: 588–602

    Google Scholar 

  9. Matsuda T, Hirano T. Interleukin-6. Biotherapy 2: 363–373

  10. Myers MA, Fleck A, Sampson B, Colley CM, Bent J, Hall G (1984) Early plasma protein and mineral changes after surgery: a two stage process. J Clin Pathol 37: 862–866

    Google Scholar 

  11. Murata A, Ogawa M, Yasada T, Nishijima T, Oka Y, Ohmachi Y, Hiraoka N, Niinobu T, Uda K, Mori T. (1990) Serum interleukin 6, c-reactive protein and pancreatic secretory trypsin inhibitor (psti) as acute phase reactants after major thoracoabdominal surgery. Immunol Invest 19: 271–278

    Google Scholar 

  12. Pullicino EA, Carli F, Poole S, Rafferty B, Malik STA, Elia M (1990) The relationship between the circulating concentrations of interleukin-6 (il-6), tumor necrosis factor (tnf) and the acute phase response to elective surgery and accidental injury. Lymphokine Res 9: 231–238

    Google Scholar 

  13. Sehgal PB (1990) Interleukin-6: molecular pathophysiology. J Invest Dermatol 94: 2S–6S

    Google Scholar 

  14. Shenkin A, Fraser WD, Series J, Winstanley FP, McCartney AC, Burns HJ, Vandamme J (1989) The serum interleukin-6 response to elective surgery. Lymphokine Res 8:123–127

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

The opinions and assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Army or the Department of Defense.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cho, J.M., LaPorta, A.J., Clark, J.R. et al. Response of serum cytokines in patients undergoing laparoscopic cholecystectomy. Surg Endosc 8, 1380–1384 (1994). https://doi.org/10.1007/BF00187340

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00187340

Key words

Navigation