腹腔镜胆囊切除术对胰岛β细胞功能的影响

目的　了解腹腔镜胆囊切除术 (LC)对人胰岛 β细胞功能的影响。 方法　 40例择期在硬膜外阻滞麻醉下胆囊切除术病人 ,随机分为腹腔镜胆囊切除术组 (LC组 ,n =2 0 )和开腹胆囊切除术组 (OC组 ,n =2 0 )。分别于术前、气 (开 )腹后 2 0分钟、术毕 2 0分钟取血样 ,用放免法测定血浆胰岛素和C肽 ,用葡萄糖氧化酶 (GOD)法测定血糖。结果　气 (开 )腹后和术毕两组血糖均高于术前。以OC组增高明显 (P <0 0 1) ;LC组仅术毕 2 0分钟高于术前 (P <0 0 5 )。胰岛素、C肽和胰岛素 /血糖比 (I/G)∶LC组气腹后、术毕均略高于术前 (P >0 0 5 )。与术前比OC组胰岛素增加不明显 (P >0 0 5 )。C肽开腹后降低 (P <0 0 5 ) ,术毕后升高 (P <0 0 5 )。I/G术毕略低于术前 (P >0 0 5 )。结论　LC应激反应轻于OC ,对胰岛 β细胞功能无明显影响。

Influence of laparoscopic cholecystectomy on pancreatic beta cell function

Objective To study the influence of laparoscopic cholecystectomy (LC) on human pancreatic beta cell function.Methods Forty patients undergoing elective cholecystectomy were randomized into LC group (n=20) and open cholecystectomy (OC) group (n=20).Blood somples were obtained before operation,at 20min after pneumoperitoneum with carbon dioxide or laparotomy,and 20min after operation.The plasma insulin and C-peptide levels were measured with radioimmunoassay technique,and blood glucose level with GOD method.Results Compared with preoperative values,the significant increases of blood glucose were observed at 20min after laparotomy and after operation in OC group (P<0.01),so was at 20min after operation in LC group (P<0.05).The plasma insulin,C-pepeide level and I/G ratio were higher druing pneumoperitoneum and after operation than those before operation in LC group.In OC group,the blood insulin was changed a little (P>0.05),C-pepeide level reduced after laparotomy (P<0.05) and increased after operation (P<0.05),and I/G ratio was lower after operation than that before operation (P>0.05).Conclusions The stress response to LC is lower than that to OC.LC has no significant effect on the function of the pancreatic beta cell.