JOURNAL OF PRACTICAL HEPATOLOGY ›› 2016, Vol. 19 ›› Issue (3): 335-338.doi: 10.3969/j.issn.1672-5069.2016.03.020

• Cholelithiasis • Previous Articles     Next Articles

Changes of peripheral blood lymphocyte subsets and serum cytokines in patients with gallbladder stones receiving laparoscopic cholecystectomy versus open cholecystectomy

Lu Debin,Liu Xiping,Hu Linzhong   

  1. Department of Surgery,Maternal and Children Health-Care Hospital,Tianmen 431700,Hubei Province,China
  • Received:2015-10-02 Online:2016-05-10 Published:2016-05-20

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