| Title: | SURGICAL IMPACT ON SERUM LEVELS OF
INSULIN-LIKE GROWTH FACTOR-1,
INSULIN-LIKE GROWTH FACTOR BINDING
PROTEIN-3 AND INTERLEUKIN-6 IN PATIENTS
UNDERGOING LAPAROSCOPIC
CHOLECYSTECTOMY: A COMPARATIVE
STUDY VERSUS OPEN CHOLECYSTECTOMY |
| Full paper | Not Available |
| Abstract: |
This study aimed at estimation of serum levels of insulin-like growth factor-1 (I0E-)), insulin-like growth factor binding protein-3 (IGFBP-3) and interleukin-6 (IL-6) in patients undergoing open (OC) or laparoscopic (LC) cholecystectomy so as to evaluate the impact of surgical procedure on their serum levels. The study comprised 30 patients (7 males & 23 females) assigned to undergo cholecystectomy for calcular cholecystitis. Laparoscopic cholecystectomy was performed according to the European your-puncture" technique Blood samples were taken preoperatively and one (POD1) and 2 (POD2) rings after surgery for determination of complete blood picture and estimation of serum IGF-1, IGFBP-3 and IL-6. The mean operative time was non-significantly prolonged in LC group, while, the mean wound length and duration of postoperative hospital stay were significantly (p<0.05) decreased in LC compared to OC group. Total leucocytic count (TLC) and the percentage of neutrophils showed progressive increase in both groups at POD1 and POD2 compared to preoperative counts; leucocytosis and neutrophilia were significant (p<0.05) at POD2 compared to levels estimated at POD) in OC group but were nonsignificant in LC group and were significantly (p<0.05) higher in OC group compared to LC group at both POD1 and POD2. Serum IGF-1 was significantly (p<0.05) decreased in both groups at both POD1 and POD2 In comparison to preoperative levels, with a signcant (p<0.05) increase at POD2 compared to levels estimated at PODI in LC group, while the difference was non-significant (p>0.05) in OC group. Moreover, serum IGF-1 was significantly (p<0.05) higher in LC compared to OC group at both POD1 and POD2. Serum IGFI3P-3 was decreased significantly (p<0.05) in OC group and non-significantly (p>0.05) in LC group in comparison to preoperative levels at both POD1 and P0132, with a significant (p<0.05) decrease in OC group compared to LC group at both POD] and POD2. Serum IGFBP-3 showed progressive decrease but with nonsignificant difference between its serum levels estimated at P01)1 and P01)2 in both groups. Serum IL-6 was increased significantly (p<0.05) in both groups in comparison to preoperative levels at both P01)1 and POD2, with a significant (p<0.05) increase in OC compared to LC group at both P01)1 and P01)2. Serum IL-6 showed progressive increase but with non-significant difference between its serum levels estimated at POD] and P01)2 in both groups. There was a positive significant correlation between serum IL-6 and percentage of neutrophils at P01)1 in both groups and a positive correlation with percentage of neutrophils at P01)2 that was significant in OC group but was non-significant in LC group. Moreover, serum IL-6 levels showed a negative correlation with serum IGFBP-3 at both P01)1 and P01)2 that correlation was significant in OC and non-significant in LC group. It could be concluded surgery induces postoperative increased serum levels of IL-6 associated with decreased levels IGF-1 and IGFBP-3, such effect was minimized in patients underwent laparoscopic surgery and explain the shortened postoperative catabolic stage. Introduction |