C-reactive protein (CRP) as a response to postoperative stress in laparoscopic cholecystectomy using the abdominal wall lift, with performed pneumoperitoneum (CO2), and in open cholecystectomy

The first laparoscopic cholecystectomy was performed thirteen years ago and rapidly became the preferred way of operation in patients suffering from cholelithiasis. The pneumoperitoneum can be responsible for haemodynamic disorders. The abdominal wall lift is an alternative way for pneumoperitoneum during laparoscopic cholecystectomy. The aim of this study was the comparative analysis of operative trauma response in the patients treated by laparoscopic cholecystectomy using abdominal wall lift and in cases which underwent open cholecystectomy or laparoscopic operation using pneumoperitoneum. The concentration of C-reactive protein was measured in patient serum before and twice after surgery. The obtained data underwent a statistic analysis. In all cases the surgery caused the marked changes of CRP-concentration. The mean level of CRP was higher three times in patients after open cholecystectomy than in cases treated by laparoscopic cholecystectomy with the use of abdominal wall lift or with performed pneumoperitoneum. During the experiment the statistically significant different between laparoscopic surgery with the use of the laparolift and laparoscopic with earlier performed pneumoperitoneum was observed. The stress and inflammatory response in cholecystectomy using abdominal wall lift was significant but smaller than the response noted in open cholecystectomy and similar to the response observed after pneumoperitoneum. The replacement of pneumoperitoneum by abdominal wall lift does not change the operative stress in laparoscopic cholecystectomy.