Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis

Table 1 Demographics and clinical characteristics of patients and type of operation performed

Parameter	Open chol-ecystectomyn = 22	LaparoscopiccholecystectomYn = 231	P value
Age (yr)	58.3 (36-84)	56.9 (32-83)	NS
Sex (F/M)	14/8	13/10	NS
ASA grade
I	3	3	NS
II	12	13	NS
III	5	6	NS
IV	2	1	NS
APACHE
score < 15	12	13	NS
score > 15	10	10	NS
MPI
score < 20	13	14	NS
score > 20	10	9	NS
Anaesthesia (min)	51.6 (46-72)	61.8 (51-81)	0.01
Operative time (min)	46.7 (40-62)	51.2 (42-64)	NS
Post-operative complications2	4 (18.1%)	1 (4.3%)	0.01
Mortality	5 (22.7%)	1 (4.3%)	0.02
Post-operative hospitalization (d)	10.2 (6-18)	5.4 (2-13)	0.02
Adjusted length of stay (d)	6.8 (6-9)	4.6 (2-6)	0.004

¹Three patients (8.1%) were converted to open surgery;

²Intra-abdominal abscess. NS: No significant; F: Female; M: Male; ASA: American Society of Anesthesiologists; APACHE: Acute Physiologic and Chronic Health Evaluation; MPI: Message passing interface.

Table 2 Demographics and clinical characteristics of four patients who developed intra-abdominal abscess

Patients (n)	1	2	3	4
Age (yr)	46	71	62	48
ASA	I	III	II	II
WBC count1 (mL)	14.800	13.600	19.200	13.200
HLA-DR2	7%	4%	7.80%	4.10%
PMN-elastase3 (mg/L)	69.6	70.2	70.6	78.2
IL-14 (pg/mL)	42.6	48.1	36.9	41.3
IL-65 (pg/mL)	415.16	381.8	402.25	408.4
Blood cultures6	Positive	Positive	Negative	Positive
Systemic endotoxin7 (pg/mL)	18.4	19.6	18.2	19.2

¹WBC count normalized 7-12 d after surgery;

²HLA-DR normalized 8-10 d after surgery;

³PMN-elastase normalized 8-12 d after surgery;

⁴ IL-1 normalized 10-13 d after surgery;

⁵IL-6 normalized 11-13 d after surgery;

⁶Blood cultures normalized 3-4 d after surgery;

⁷Systemic endotoxin concentration normalized 5-6 d after surgery. ASA: American society of anesthesiologists; WBC: White blood cells; HLA-DR: Human leukocyte antigen-DR; PMN: Polymorphonuclear; IL-1: Interleukin-1.

Table 3 The number of blood cultures positive for organism was increased in the open cholecystectomy group as compared with the laparoscopic cholecystectomy group n (%)

Time intervention	Opencholecystectomy(n = 22)	Laparoscopic cholecystectomy(n = 20)	P value
Within 60 min before	10 (45.4)	8 (40)	NS
Within 60 min after1	10 (45.4)	4 (20)	0.001
Within 7 d after	1 (4.5)	0	NS

¹Significant difference between groups, using Fisher’s exact tests, P < 0.05; NS: No significant difference between groups, using χ² o Fisher’s exact tests, P > 0.05.