关键词: 胆囊结石, 开腹胆囊切除术, 腹腔镜胆囊切除术, 淋巴细胞亚群, 细胞因子

Abstract: Objective To compare the changes of peripheral blood lymphocyte subsets and serum cytokines in patients with gallbladder stones receiving laparoscopic cholecystectomy （LC） versus open cholecystectomy （OC）. Methods A retrospective analysis was made in 57 patients with gallbladder stones receiving LC and 57 receiving OC. The peripheral blood T lymphocyte subsets were detected by FACSCalibur flow cytometry，and serum interleukin-6（IL-6），tumor necrosis factor（TNF）-alpha and C-reactive protein（CRP） levels were detected by ELISA. Results The amount of bleeding in LC group was significantly lower than in OC group[（66.4±17.6） ml vs. （103.5±15.5） ml，P<0.05]；postoperative intestinal peristalsis function restoration and hospitalization times in LC group were significantly shorter than in OC group [（1.5±0.5） d vs.（3.0±1.0） d，P<0.05 and （5.0±1.0） d vs. （8.0±2.0） d，respectively，P<0.05）]；the peripheral blood CD3+T lymphocyte percentages at day one，three and seven post-operation were （29.4±5.6） %，（38.9±6.3） % and （52.1±7.7） % in OC group，significantly lower than those in the LC group [（36.0±6.1）%，（46.5±7.5） % and （63.8±8.8） %，P<0.05]；the CD4+T lymphocyte were （21.9±4.2） %，（28.8±4.4） % and （36.0±8.3） % in the OC group，significantly lower than those in the LC group[（27.7±6.4）%，（34.9±8.0） % and（44.9±8.0） %，P<0.05]；the peripheral blood CD8+ T lymphocyte in the OC groups were （37.1±6.8） %，（32.3±7.0） % and （29.5±7.4） %, significantly lower than those in the LC groups [（32.4±7.4）%,（29.5±6.9）% and（25.3±7.0） %，P<0.05]；serum levels of IL-6 at day one，three and seven post-operation in OC group were （95.9±10.1） pg/L，（58.4±8.1） pg/L and（33.8±4.6）pg/L，significantly higher than those in the LC group ［（72.0±9.4）pg/L，（35.9±5.2）pg/L and（19.0±3.4）pg/L，P<0.05］；serum levels of TNF-α in OC group were（49.0±10.2）ng/L，（65.8±14.1）ng/L and（41.5±8.8）ng/L，significantly higher than those in the LC group[（34.0±9.9）ng/L，（40.7±10.6）ng/L and（19.8±7.7）ng/L，P<0.05]；serum levels of CRP in OC group were （32.4±3.6） mg/L，（25.8±2.7）mg/L and（15.4±4.2）mg/L，significantly higher than those in the LC group [（20.5±3.0）mg/L，（12.4±2.0）mg/L and（6.6±1.1）mg/L，P<0.05]；the incidence of adverse reactions in the LC group was 17.5%，significantly lower than that in the OC group （31.6%，P<0.05）. Conclusions The laparoscopic cholecystectomy has smaller operation trauma， lighter stress response and immune function suppression，quicker postoperative recovery and fewer adverse reactions.

Key words: Gallbladder stones, Open cholecystectomy, Laparoscopic cholecystectomy, Lymphocyte subsets, Cytokines