Decrease in muscle glutamine, ribosomes, and the nitrogen losses are similar after laparoscopic compared with open cholecystectomy during the immediate postoperative period

Background, The purpose of the study was to compare the postoperative muscle amino acid pattern, the ribosome concentration and size distribution and postoperative nitrogen balance in patients who underwent either laparoscopic or open cholecystectomy. Methods, Patients who underwent cholecystectomy by means of either laparoscopy (n = 8; LAP) or laparotomy (n = 8; OPEN) were studied. The concentrations of amino acids, ribosomes, and polyribosomes, reflecting protein synthesis, were determined in skeletal muscle tissue before operation and on postoperative day 2. The cumulated nitrogen balance was determined. Results. Decreases in muscle glutamine (26.7% +/- 8.4% in the LAP group and 30.3% +/- 4.5% in the OPEN group) and in polyribosomes (28.7% +/- 6.5% in the LAP group and 23.6% +/- 8.5% in the OPEN group) were observed without differences between the groups (mean +/- SEM). The nitrogen losses were similar in both groups (15.2 +/- 1.6 gm in the LAP group and 15.5 +/- 1.2 gm in the OPEN group). Conclusions. A stress response with effects on amino acid and protein metabolism in muscle is present also after laparoscopic cholecystectomy. On postoperative day 2 this response is of similar magnitude after both the laparoscopic and the open procedures.