Purpose
To investigate the immunologic effect of the gasless laparoscopic procedure, we compared it with an immunologically effective, gas insuffulated (pneumoperitoneal) laparoscopic procedure. Methods
The temporal immune responses in two similar groups of patients randomized to gas vs gasless laparoscopic cholecystectomy were analyzed. The patients were matched by age, weight, and operation time. Immune parameters, including serum white blood
cell
count and TNF-α, INF-γ, IL-6, IL-8, cortisol and ESR levels, were assessed preoperatively and on postoperative days 1 and 3 between the two groups. Also during the operations, cytokines were checked in cultured peritoneal macrophages. Results
The results were as follows: 1) Serum cortisol and ESR levels
were not statistically different between the two groups. White blood cell counts were also not statistically different. 2) The preoperative and postoperative day 1 and days 3 serum TNF-α, INF-γ, IL-6, and IL-8 levels in the two group were not
statistically different. However, an immediate decrease cytokine levels was significant in both groups after postoperative day 1. 3) Especially cytokine levels were more increased in cultured peritoneal macrophages than in serum, but difference
between
the two groups was not statistically significant. Conclusion
From our results the beneficial effects of immunology in a gasless laparoscopic procedure were not different from those in a gas laparoscopic procedure. Rather, immediate preservation of the immune function during the postoperative period was
detected
in both groups.
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