A comparative study between conventional and laparoscopic cholecystectomy: Neutrophilic activities and cytochemical changes

Neutrophilic activity and cytochemical changes were assessed in patients undergoing laparoscopic cholecystectomy versus conventional cholecystectomy. Myeloperoxi-dase (MPO), acid phosphatase (AP) and leucocytic alkaline phosphatase (LAP) were used to estimate cytochemical activity while the nitroblue tetrazolium (NBT) dye reduction test was used to assess the phagocytic capacity of the neutrophils. No significant leucocytosis could be detected after 45 minutes of surgery in both groups, but significant leucocytosis and higher percentages of neutrophils were observed at 72 hours after surgery in both groups. The pattern of leucocytosis and neutrophilia was significantly higher in the conventional cholecystectomy group as compared to the laparoscopic cholecystectomy group. As regards NBT there was a significant reduction after 45 minutes followed by a significant increase after 72 hours in both groups. Neutrophilic enzymatic activities (MPO, AP and LAP) increased significantly 72 hours after surgery in both groups. There were no significant differences between the two groups in phagocytic or enzymatic activities. These data demonstrate that the laparoscopic approach to cholecystectomy is associated with significantly less leucocytosis and neutrophilia without significant less leucocytosis and neutrophilia without significant difference in the phagocytic or enzymatic activities of neutrophils.