Surgical Endoscopy

, Volume 8, Issue 10, pp 1216–1220 | Cite as

Interleukin-6 and coagulation-fibrinolysis fluctuations after laparoscopic and conventional cholecystectomy

  • G. Vander Velpen
  • F. Penninckx
  • R. Kerremans
  • J. Van Damme
  • J. Arnout
Original Articles


This study assesses quantitatively the fluctuations of interleukin-6 (IL-6) and coagulationfibrinolysis proteins in patients undergoing elective laparoscopic (n=14) and conventional (n=10) cholecystectomy. The patients in both groups were comparable in age and sex. Serum levels of interleukin-6, and plasma levels of fibrinogen, von Willebrand factor-antigen, tissue-type plasminogen activator-antigen, and plasminogen activator inhibitor-1 were determined for up to 48 h postoperatively. The postoperative changes of all parameters tested were comparable in both patient groups with a trend toward a higher interleukin-6 response at 8 h postincision (NS) and a trend toward a higher fibrinolysis inhibition (NS) after conventional cholecystectomy.

Key words

Cholecystectomy Laparoscopic Conventional Surgical stress response Interleukin-6 Coagulation Fibrinolysis 


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  1. 1.
    Baigrie RJ, Lamont P, Kwiathkowski D, Dallman M, Morris P (1992) Systemic cytokine response after major surgery. Br J Surg 79: 757–760Google Scholar
  2. 2.
    Calandra T, Gerain J, Heumann D, Baumgartner J-D, Glauser M (1991) High circulating levels of interleukin-6 in patients with septic shock: evolution during sepsis, prognostic value, and interplay with other cytokines. Am J Med 91: 23–29Google Scholar
  3. 3.
    Chakrabarti R, Hocking ED, Fearnley GR (1969) Reaction pattern to three stresses—electroplexy, surgery and myocardial infarction—of fibrinolysis and plasma fibrinogen. J Clin Pathol 22: 659–662Google Scholar
  4. 4.
    Chambers LM, Tompkins RG, Burke JF (1991) Response to trauma. In: Pollock A (ed) Immunology in surgical practice, chapter 4. Edward Arnold, London, pp 40–69Google Scholar
  5. 5.
    Collins GJ, Barber JA, Zajtchukr R, (1977) The effects of operative stress on the coagulation profile. Am J Surg 133: 612Google Scholar
  6. 6.
    Cruickshank A, Fraser W, Burns H, Van Damme J, Shenkin A (1990) Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci 79: 57(1–5)Google Scholar
  7. 7.
    Cuschieri A, Dubois F, Mouiel J, Mouret P (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161:385–387Google Scholar
  8. 8.
    Declerck P, Aless MC, Verstreken K, Kruithof E, Juhan-Vague I, Collen D (1988) Measurement of plasminogen activator inhibitor-1 in biological fluids with a mucine monoclonal-based enzyme-linked immunosorbent assay. Blood 71: 220–225Google Scholar
  9. 9.
    Di Padova F, Pozzi C, Tondre MJ, Tritapepe R (1991) Selective and early increase of IL-1 inhibitors, IL-6 and cortisol after elective surgery. Clin Exp Immunol 85: 137–142Google Scholar
  10. 10.
    Fischer C, Gill C, Forrester M, Nakamura R (1976) Quantitation of ‘acute-phase proteins’ postoperatively. Value in detection and monitoring of complications. Am J Clin Pathol 66: 840–846Google Scholar
  11. 11.
    Gordon-Smith DC, Hickman JA, Le Quesne LP (1974) Postoperative fibrinolytic activity and deep vein thrombosis. Br J Surg 61: 213–218Google Scholar
  12. 12.
    Griffiths NJ, Woodford M, Irving MH (1977) Alteration in fibrinolytic capacity after operation. Lancet ii: 635–637Google Scholar
  13. 13.
    Hoffmann J, Verhappen M (1988) Automated nephelometry of fibrinogen: analytical performance and observations during thrombolytic therapy. Clin Chem 34: 2135–2140Google Scholar
  14. 14.
    Holvoet P, Cleemput H, Collen D (1985) Assay of human tissue-type plasminogen activator (t-PA) with an enzyme-linked immunosorbent assay (ELISA) based on three mucine monoclonal antibodies to t-PA. Thromb Haemost 54: 684–687Google Scholar
  15. 15.
    Kluft C, Verheijen JH, Jie AFH, Rijken DC, Preston FE, SueLing HM, Jespersen J, Aasen AO (1985) The postoperative fibrinolytic shutdown: a rapidly reverting acute phase pattern for the fast-acting inhibitor of tissue-type plasminogen activator after trauma. Scan J Clin Lab Invest 45: 605–610Google Scholar
  16. 16.
    MacIntyre IMC, Webber RG, Crispin JR, Jones DRB, Wood JK, Allan NC, Prescott RJ, Ruckley CV (1976) Plasma fibrinolysis and postoperative deep vein thrombosis. Br J Surg 63: 694–697Google Scholar
  17. 17.
    Mealy K, Gallagher H, Barry M, Lennon F, Traynor O, Hyland J (1992) Physiological and metabolic responses to open and laparoscopic cholecystectomy. Br J Surg 79: 1061–1064Google Scholar
  18. 18.
    Molloy RG, Mannick J, Rodrick M (1993) Cytokines, sepsis and immunomodulation. Br J Surg 80: 289–297Google Scholar
  19. 19.
    Nijsten M, Degroot E, Tenduis H, Klasen H, Hack C, Aarden L (1987) Serum levels of interleukin-6 and acute phase responses. Lancet 2: 921Google Scholar
  20. 20.
    Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, Roby SR, Front ME, Carey LC (1991) Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients. Ann Surg 213: 3–12Google Scholar
  21. 21.
    Roitt I (1991) The acquired immune response. Production of effectors. In: Roitt I (ed), Essential immunology, 7th edition, chapter 7. Blackwell Scientific Publications, Oxford, pp 141–147Google Scholar
  22. 22.
    Roumen RM, Meurs PA, Kuypers H, Kraak WA, Sauerwein RW (1992) Serum interleukin-6 and C-reactive protein responses in patients after laparoscopic or conventional cholecystectomy. Eur J Surg 158: 541–544Google Scholar
  23. 23.
    Seyfer AE, Seaber A, Dombrose FA, Urbaniak JR (1981) Coagulation changes in elective surgery and trauma. Ann Surg 193: 210–213Google Scholar
  24. 24.
    Shenkin A, Fraser W, Series J, Winstanley F, McCartney A, Burns H, Van Damme J (1989) The serum interleukin-6 response to elective surgery. Lymphokine Res 8: 123–126Google Scholar
  25. 25.
    Shimomura K, Ohtomo Y, Ishizaki Y, Noie T, Abe H, Nayeem SA, Bandai Y, Idezuki Y (1992) Peripheral venous pressure analysis in the lower limb during pneumoperitoneum in clinical laparoscopic cholecystectomy. Surg Endosc 6: 87Google Scholar
  26. 26.
    Soper N, Barteau JA, Clayman RV, Ashley SW, Dunnegan DL (1992) Comparison of early postoperative results for laparoscopic versus standard open cholecystectomy. Surg Gynecol Obstet 174: 114–118Google Scholar
  27. 27.
    Tornai I, Declerck P, Smet L, Arnout J, Deckmyn H, Caekebeke-Peerlinck K, Vermylen J (1991) Measurement of von Willebrand factor-antigen in plasma and platelets with an enzyme-linked immunosorbent assay based on two mucine monoclonal antibodies. Haemostasis 21: 125–134Google Scholar
  28. 28.
    Van Snick J (1990) Interleukin-6: an overview. Annu Rev Immunol 8: 253–278Google Scholar
  29. 29.
    Vitale GC, Collet D, Larson GM, Cheadle WG, Miller FB, Perissat J (1991) Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients. Am J Surg 161: 396–398Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1994

Authors and Affiliations

  • G. Vander Velpen
    • 1
  • F. Penninckx
    • 1
  • R. Kerremans
    • 1
  • J. Van Damme
    • 2
  • J. Arnout
    • 3
  1. 1.Department of Abdominal Surgery, U.Z. GasthuisbergUniversity of LeuvenLeuvenBelgium
  2. 2.Department of Virology and Rega Institute, U.Z. GasthuisbergUniversity of LeuvenLeuvenBelgium
  3. 3.Department of Pathophysiology, U.Z. GasthuisbergUniversity of LeuvenLeuvenBelgium

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