Hepatocyte growth factor and interleukin - 6 as markers for evaluation of tissue trauma and stress response after laparoscopic and open cholecystectomy

ABSTRACT

The present prospective r and omized study was planned to compare the clinical outcome and tissue trauma after two cholecystectomy techniques; namely, open and laparoscopic surgical procedures. Forty patients were r and omized to either laparoscopic or open approaches. Blood samples were drawn preoperatively as well as at 12 and 36 hours following the operation. Hepatocyte growth factor [HGF] and interleukin-6 [IL-6] levels were used to evaluate cytokine release, while C-reactive protein [CRP] and morning cortisol were used to clarify the inflammatory response. It was found that hepatocyte growth factor and interleukin-6 elevation in response to stress and tissue trauma is an inevitable metabolic response in both laparoscopic and open approaches, this is associated with increased acute phase reactants [CRP and stress hormones as morning cortisol]. However, laparoscopic surgery exhibited significant lower levels of both hepatocyte growth factor and interleukin-6 at 36 hours postoperatively, which can be attributed to the amelioration of tissue trauma on using the laparoscopic approach. Thus, it can provide less perception of pain as well as shorter convalescence time and postoperative hospital stay