Transient insulin resistance during the laparoscopic versus open cholecystectomy
Dusan Micic1, Snezana Polovina3, Jelena Micic2, Zlatibor Loncar1, Dragan Micic4 & Vladimir Djukic1
Aim: The aim of our study was to investigate is surgical stress induce alterations in insulin sensitivity in the course of cholecystectomy performed in two differnt procedures: as a open surgery and as laparascopic operation.
Material and methods: The homeostasis assessment model (HOMA) was used to determine insulin sensitivity before and in the first, third and seventh day after the operation. Patients were divided int two groups: group A (open cholecystectomy; n=8; mean age 38.0±3.3; mean BMI 26.8938±1.5679) and group B (laparoscopic cholecystectomy; n=7; mean age 39.6±4.1; mean BMI 26.5867±1.8531).
Results: There were no diferences in HOMA index between group A and B before the operation (mean 2.4010±0.3230 vs 1.9798±0.6985; P>0.05) as well as for day 1 (2.5448±0.6044 vs 1.8370±0.5714; P>0.05) and day 7 (0.6494±0.4349 vs 0.7232±0.3898; P> 0.05). Group B had higher HOMA index at day 3 (7.5619±2.3360 vs 2.8016±0.7670; P<0.05).
Conclusion: There is transient increase in HOMA index after the operation in both procedures, compatible with deterioration in insulin sensitivity due to stressresponse that is normalized a week after the operation.