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Laparoscopic cholec...
Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle
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- Essén, Pia (author)
- Depts. of Anesth. and Intensive Care, Huddinge University Hospital, Stockholm, Sweden; Depts. of Anesth. and Intensive Care, Karolinska Institute, Stockholm, Sweden
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- Thorell, Anders (author)
- Karolinska Institutet
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- McNurlan, Margaret A. (author)
- Karolinska Institutet
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- Anderson, Susan (author)
- Rowett Research Institute, Aberdeen, United Kingdom
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- Ljungqvist, Olle, 1954- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden
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- Wernerman, Jan (author)
- Depts. of Anesth. and Intensive Care, Huddinge University Hospital, Stockholm, Sweden; Depts. of Anesth. and Intensive Care, Karolinska Institute, Stockholm, Sweden
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- Garlick, Peter J. (author)
- Department of Surgery, State University of New York, Stony Brook NY, United States
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Karolinska Institutet Depts of Anesth. and Intensive Care, Huddinge University Hospital, Stockholm, Sweden; Depts. of Anesth. and Intensive Care, Karolinska Institute, Stockholm, Sweden (creator_code:org_t)
- Lippincott Williams & Wilkins, 1995
- 1995
- English.
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In: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 222:1, s. 36-42
- Related links:
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https://www.ncbi.nlm...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- OBJECTIVE:The authors determined the effect of laparoscopic cholecystectomy on protein synthesis in skeletal muscle. In addition to a decrease in muscle protein synthesis, after open cholecystectomy, the authors previously demonstrated a decrease in insulin sensitivity. This study on patients undergoing laparoscopic and open surgery, therefore, included simultaneous measurements of protein synthesis and insulin sensitivity.SUMMARY BACKGROUND DATA:Laparoscopy has become a routine technique for several operations because of postoperative benefits that allow rapid recovery. However, its effect on postoperative protein catabolism has not been characterized. Conventional laparotomy induces a drop in muscle protein synthesis, whereas degradation is unaffected.METHODS:Patients were randomized to laparoscopic or open cholecystectomy, and the rate of protein synthesis in skeletal muscle was determined 24 hours postoperatively by the flooding technique using L-(2H5)phenylalanine, during a hyperinsulinemic normoglycemic clamp to assess insulin sensitivity.RESULTS:The protein synthesis rate decreased by 28% (1.77 +/- 0.11%/day vs. 1.26 +/- 0.08%/day, p < 0.01) in the laparoscopic group and by 20% (1.97 +/- 0.15%/day vs. 1.57 +/- 0.15%/day, p < 0.01) in the open cholecystectomy group. In contrast, the fall in insulin sensitivity after surgery was lower with laparoscopic (22 +/- 2%) compared with open surgery (49 +/- 5%).CONCLUSIONS:Laparoscopic cholecystectomy did not avoid a substantial decline in muscle protein synthesis, despite improved insulin sensitivity. The change in the two parameters occurred independently, indicating different mechanisms controlling insulin sensitivity and muscle protein synthesis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Fysiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Physiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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