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Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle
Depts. of Anesth. and Intensive Care, Huddinge University Hospital, Stockholm, Sweden; Depts. of Anesth. and Intensive Care, Karolinska Institute, Stockholm, Sweden.
Department of Surgery, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Rowett Research Institute, Aberdeen, United Kingdom.
Rowett Research Institute, Aberdeen, United Kingdom.
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1995 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 222, no 1, p. 36-42Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.

SUMMARY BACKGROUND DATA:

Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.

METHODS:

Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(2H5)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.

RESULTS:

The protein synthesis rate decreased by 28% (1.77 +/- 0.11%/day vs. 1.26 +/- 0.08%/day, p < 0.01) in the laparoscopic group and by 20% (1.97 +/- 0.15%/day vs. 1.57 +/- 0.15%/day, p < 0.01) in the open cholecystectomy group. In contrast, the fall in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2%) compared with open surgery (49 +/- 5%).

CONCLUSIONS:

Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 1995. Vol. 222, no 1, p. 36-42
National Category
Physiology Surgery
Identifiers
URN: urn:nbn:se:oru:diva-63859DOI: 10.1097/00000658-199507000-00006ISI: A1995RK50800006PubMedID: 7618966Scopus ID: 2-s2.0-0029028973OAI: oai:DiVA.org:oru-63859DiVA, id: diva2:1170981
Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-07Bibliographically approved

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Ljungqvist, Olle

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