Metabolic and Inflammatory Responses After ERCP Procedure as a Minor Surgery

Gokhan Tolga Adas, MD, Ahu Kemik, MD, Mine Adas, MD, Bora Koc, MD, Emin Gurbuz, MD, Servet Karahan, prof

Okmeydani Training and Research Hospital, Department of Surgery/Istanbul

Background: We aim to evaluate the metabolic and inflammatory responses after ERCP procedure in patients who have common bile duct stones.

Methods: Between September 2009 and October 2010, we studied prospectively 50 patients who diagnosed with common bile duct stones. Our study was included patients who had previously been suspected with common biliary duct stone via radiological and biochemical examinations. We investigated parameters of proinflammatory cytokines (IL-1β, IL-6, Il-8, IL-12, IFN-γ, TNF-α), anti inflammatory cytokines (IL-4, IL-10, IL-13), stress hormones (ACTH, cortisol, growth hormone, aldosterone) and acute phase reactan (CRP). All venous blood samples were taken firstly 1hr before endoscopic intervention as a control. After ERCP procedure, venous blood samples were taken two more times, the first in 1hr, the second in 24 hours.

Results: 50 patients who had performed successfully ERCP procedure due to common bile duct stones. All of them had higher serum cytokine levels (p< 0.01) after ERCP procedure than before endoscopic intervention. Also we didn’t find any differences IL-13 level in cytokines 24 hour after ERCP. A significiant differences (p<0,01) were found in hormones of ACTH, cortizol, GH, aldesterone levels 1h after ERCP and 24h after ERCP except GH level (p>0.05). There was significiant differences CRP level in early and late time after ERCP procedure.

Conclusion: ERCP procedure is a kind of invasive attempt as known, also causes, with its effects, systemically inflammatory response in the body. This response, mostly not staying at the local stage, becomes systemic inflammatory response. Therefore, before ERCP is performed, the applications of other non-invasive methods of diagnosis are strongly advised.

Session: Poster Presentation

Program Number: P341

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