Background / Aim : Laparoscopic cholecystectomy is a so called mini-invasive surgical procedure, and on this basis, we investigated whether and how the immune response is modified in patients after laparoscopic cholecystectomy compared to pa­tients who underwent open cholecys­tectomy. Also we focused on the T cell secretion of cytokines that regu­late the critical balance of either T helper type-l (Th1) - and T helper type-ll (Th2) - cell mediated immune responses and the pro- inflammatory activities.
Methods : In a prospective study, immunological data of 38 patients submitted to laparoscopic cholecys­tectomy ( LC) and 18 patients under­going open cholecystectomy (OC) for symptomatic cholecystolithiasis were compared. Patients with acute chole­cystitis and patients developing posto­perative complications or receiving immunosuppressive medications were excluded. Production of interfer-on (IFN)-y, interleukin(IL)-2, (IL)-4, and tumor necrosis factor (TNF)-a, by isolated T cells stimulated by cross linking of CD3 and CD28 was evaluat­ed preoperatively as well as on posto­perative days 1 and 6 or 7. Cytokines were measured by immunoenzymo-metric assay. Also, skin Multitest was done to share in evaluation of cell me­diated immune response.
Results : IFN -7, TNF-a and IL-2 production by T cells decreased sig­nificantly by 48.3%, 36.6%, and 36.8%, respectively, on postoperative day 1 after OC, but not after LC. These results indicate severe sup­pression of Th1- type and pro-