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-