Effects of laparoscopic and conventional (open) cholecystectomy on human leukocyte antigen-DR expression in peripheral blood monocytes: correlations with immunologic status

It is well known that surgery significantly decreases immune responses. Laparoscopic cholecystectomy (LC) is a "miniinvasive" surgical procedure; and on the basis of this consideration we have investigated if and how the immune response is modified in patients after laparoscopic cholecyste...

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Bibliographic Details
Published in:World journal of surgery 1999-01, Vol.23 (1), p.18-22
Main Authors: Carlei, F, Schietroma, M, Cianca, G, Risetti, A, Mattucci, S, Ngome Enang, G, Simi, M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Cell Count
Cholecystectomy - adverse effects
Cholecystectomy, Laparoscopic - adverse effects
Cholelithiasis - immunology
Cholelithiasis - surgery
Female
HLA-DR Antigens - blood
Humans
Male
Middle Aged
Monocytes - immunology
Postoperative Complications - immunology
Prospective Studies
Treatment Outcome
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Summary:It is well known that surgery significantly decreases immune responses. Laparoscopic cholecystectomy (LC) is a "miniinvasive" surgical procedure; and on the basis of this consideration we have investigated if and how the immune response is modified in patients after laparoscopic cholecystectomy compared to patients who underwent open cholecystectomy. Immune activity [neutrophils, total lymphocytes count, lymphocytes subpopulations, human leukocyte antigen-DR (HLA-DR)] was evaluated in 53 patients 1 day before surgery and respectively, 1, 3, and 6 days after surgery; 26 patients underwent "open" cholecystectomy and 27 LC. A day after surgery, patients with open cholecystectomy showed a significant increase (p < 0.05) in plasma neutrophils, while they were almost unchanged in LC patients. Monocyte antigen HLA-DR was reduced in patients with "open" cholecystectomy. We recorded two cases (7.6%) of respiratory tract infection in the "open" group. In conclusion, LC strongly reduces postoperative (p.o.) pain and hospitalization, and it promotes earlier recovery and return to normal activity, avoiding p.o. immunosuppression, mostly due to conservation of HLA-DR activity, with less p.o. morbidity compared to that seen with open surgery.
ISSN:0364-2313
DOI:10.1007/s002689900559