Background: Surgical trauma triggers an important postoperative stress response characterized by significantly elevated levels of cytokines, an event that can favor the emergence of immune disorders which lead to disturbances in the patient's body defense. The magnitude of postoperative stress is related to the degree of surgical trauma.
Aim: To evaluate the expression of pro-inflammatory (TNF-α, IFN-γ, IL-1β, and IL-17) and anti-inflammatory (IL-4) cytokines in patients submitted to conventional and single-port laparoscopic cholecystectomy before and 24 h after surgery.
Methods: Forty women with symptomatic cholelithiasis, ranging in age from 18 to 70 years, participated in the study. The patients were divided into two groups: 21 submitted to conventional laparoscopic cholecystectomy and 19 to single-port laparoscopic cholecystectomy.
Results: Evaluation of the immune response showed no significant difference in IFN-γ and IL-1β levels between the groups or time points analyzed. With respect to TNF-α and IL-4, serum levels below the detection limit (10 pg/ml) were observed in the two groups and at the time points analyzed. Significantly higher postoperative expression of IL-17A was detected in patients submitted to single-port laparoscopic cholecystectomy when compared to preoperative levels (p=0.0094).
Conclusions: Significant postoperative expression of IL-17 was observed in the group submitted to single-port laparoscopic cholecystectomy when compared to preoperative levels, indicating that surgical stress in this group was higher compared to the conventional laparoscopic cholecystectomy.
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http://dx.doi.org/10.1590/0102-6720201600030009 | DOI Listing |
Surg Open Sci
January 2025
Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Background: The elderly population in the United States is rapidly expanding. Older patients over age 65 with acute cholecystitis may face greater perioperative risk compared to younger patients undergoing urgent laparoscopic cholecystectomy. We aimed to characterize trends in utilization and outcomes of inpatient cholecystectomy across the United States stratified by age.
View Article and Find Full Text PDFSurg Endosc
January 2025
Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1 Hasama-Machi, Yufu, Oita, 879-5593, Japan.
Background: The surgical difficulty of laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) and the risk of bile duct injury (BDI) depend on the degree of fibrosis and scarring caused by inflammation; therefore, understanding these intraoperative findings is crucial to preventing BDI. Scarring makes it particularly difficult to perform safely and increases the BDI risk. This study aimed to develop an artificial intelligence (AI) system to indicate intraoperative findings of scarring in LC for AC.
View Article and Find Full Text PDFJ Pediatr Surg
January 2025
Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 42, Torrance, CA 90502, USA; Division of Pediatric Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 77-123 CHS, Los Angeles, CA 90095, USA. Electronic address:
Background: Rural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.
Methods: The Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018.
Health Policy
November 2024
Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.
The appropriate use of day surgery has been shown to provide the same or better outcomes for patients and to increase hospital efficiency. However, it is often underutilised, and rates can vary widely across hospitals. This study examines variation in day-surgery rates across Irish public hospitals and identifies the characteristics associated with these variations.
View Article and Find Full Text PDFCureus
December 2024
Anaesthesia, Medway NHS Foundation Trust, Kent, GBR.
Laparoscopic cholecystectomy has become the gold standard for treating symptomatic cholelithiasis due to its minimally invasive nature and faster recovery times compared to traditional open surgery, but it is not without risks. A key component of this procedure is the creation of pneumoperitoneum. This is achieved by insufflating the abdomen with carbon dioxide (CO2).
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