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Mini-laparotomy and full laparotomy, but not laparoscopy, alter hepatic macrophage populations in a rat model

  • N. K. Jesch
  • G. Vieten
  • T. Tschernig
  • W. Schroedel
  • B. M. Ure
Original article

Abstract

Background

Immune function is better preserved by laparoscopic versus conventional surgery. Numerous mediators of the systemic trauma response are synthesized and/or regulated by the liver. However, it has been stated that the advantages of laparoscopic surgery are no more obvious when conventional operations are performed via mini-laparotomy. We set out to compare the impact of laparoscopy and mini- and full laparotomy on the hepatic macrophage populations.

Methods

Male Lewis rats were subjected to anesthesia alone (control), mini-laparotomy (1 cm), full laparotomy (7 cm), or laparoscopy for 60 min. Endpoints were the total protein in the peritoneal lavage fluid, hepatic ED-1 cells (recruited monocytes), hepatic ED-2 cells (Kupffer cells), the expression of OX-6 in the liver, and C-reactive protein (CRP) in plasma.

Results

Protein in the peritoneal lavage fluid increased significantly after all interventions. Full laparotomy was accompanied by an enhancement in ED-1-positive monocytes in the liver parenchyma compared to all other groups (p < 0.001). Mini- and full laparotomy led to an increase in ED-2-positive Kupffer cells (p < 0.001). Laparoscopy did not affect the number of monocytes/macrophages. There was no significant alteration of OX-6 expression in either group. No change in the cellular composition in the periportal fields was observed. The CRP plasma levels did not significantly differ between groups.

Conclusions

Laparoscopy completely prevents hepatic macrophage populations from expansion and normal cell disposition is preserved. Laparotomy, irrespective of incision size, increases the number of Kupffer cells. Moreover, full laparotomy, but not mini-laparotomy or laparoscopy, causes an increase in hepatic monocyte recruitment. The regulating pathways after surgery differ from other immunologic challenges, such as sepsis, in which immunocompetent cells accumulate and are stimulated in the periportal fields.

Keywords

Laparoscopy Laparotomy Rat Liver Macrophage Monocyte 

Notes

Acknowledgments

The excellent technical assistance of Karin Westemann is very much appreciated. This research was supported by a grant (HiLF) from the Hannover Medical School, Hannover, Germany.

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Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • N. K. Jesch
    • 1
  • G. Vieten
    • 1
  • T. Tschernig
    • 2
  • W. Schroedel
    • 3
  • B. M. Ure
    • 1
  1. 1.Department of Pediatric SurgeryHannover Medical SchoolHannoverGermany
  2. 2.Department of Functional and Applied AnatomyHannover Medical SchoolHannoverGermany
  3. 3.Institute of Bacteriology and Mycology, Faculty of Veterinary MedicineUniversity of LeipzigLeipzigGermany

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