COMPARATIVE STUDY IN GENERAL STRESS RESPONSE BETWEEN OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Major body injuries, surgical, traumatic diseases or infections disturbed normal homeostatic condition of the body and evoke reproducible metabolic, hormonal and inflammatory and haemodynamic responses. The body responds by mounting an acute phase response which is characterized by a drastic change in the production of a variety of proteins by the hepatocytes. These changes are caused by inflammatory mediators and cytokines.

The metabolic changes including hypermetabolism, altered carbohydrates and protein metabolism with hyperglycemia, increase thermogenesis associated with negative nitrogen balance reflecting catabolism with synthesis of acute phase proteins, sodium and water retention and increase lipolysis because major body fuel become fat, the magnitude of these changes is proportional to the extent of injury.

The hormonal changes in response to stress can be classified into three groups: (a) those concerned with fluids and electrolytes balance (aldosterone, antidiuretic hormones, kenin, and angiotensin, (b) those concerned with catabolic effect on the body (cortisol, adrenaline, noradrenaline and glucagon) and (c) third group concerned with anabolic effect (insulin-growth hormone, thyroxine).