Background: Surgical injury is associated with oxidative stress, often due to ischemia/reperfusion
injury. During laparoscopy, increased intra-abdominal pressure caused by pneumoperitoneum may
cause splanchnic ischemia followed by reperfusion due to deflation. We measured several markers
of oxidative stress in patients undergoing laparoscopic cholecystectomy (LC) versus open cholecystectomy
(OC) to find if these surgical procedures result in different patterns of oxidative stress.
Methods: This prospective study enrolled 43 patients with symptomatic cholelithiasis, of whom 21
underwent open, and 22 laparoscopic, cholecystectomy. Twenty healthy adults comprised the control
group. Total antioxidant status (TAS), superoxide dismutase (SOD), endogenous peroxide level
(POX), oxidized low density lipoprotein (oLDL) autoantibodies (oLAb), and neopterin were measured
preoperatively and on postoperative days 1, 3, and 7.
Results: POX values decreased significantly on postoperative day 1 in the OC (P < 0.01), but not
in the LC, group. On postoperative day 7, POX values were higher than preoperatively in both
groups (P < 0.01) with no difference between the LC and OC groups. Significant postoperative elevations
of oLAb and neopterin levels were observed only on postoperative day 7 in the OC group.
There were no changes of oLAb and neopterin levels in the LC group. TAS and SOD levels did not
change after either LC or OC.
Conclusion: Cholecystectomy, either open or laparoscopic, caused only moderate oxidative stress.
Open cholecystectomy caused changes of oLAb and neopterin, suggesting more severe oxidative
stress, and a possible role of reactive oxygen species in the healing of the laparotomic wound.
