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Am J Physiol Endocrinol Metab 277: E591-E596, 1999;
0193-1849/99 $5.00
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Vol. 277, Issue 4, E591-E596, October 1999

Inhibition of liver protein synthesis during laparoscopic surgery

Hans Barle1, Björn Nyberg2, Stig Ramel2, Pia Essén1, Margaret A. McNurlan3, Jan Wernerman1, and Peter J. Garlick3

1 Department of Anesthesiology and Intensive Care and 2 Department of Surgery, Huddinge University Hospital, Karolinska Institute, S-141 86 Huddinge, Sweden; and 3 Department of Surgery, State University of New York at Stony Brook, Stony Brook, New York 11794-8191

Previous studies have indicated that laparoscopic surgery is associated with a decline in liver protein synthesis. In this study, the fractional synthesis rate (FSR) of total liver protein and albumin was measured in patients undergoing elective laparoscopic cholecystectomy at different times after commencing the procedure (n = 8 + 8). Liver biopsy specimens were taken after 15 min of surgery in an "early" group and after 49 min of surgery in a "late" group. The liver FSR was higher in the early group (24.1 ± 4.7%/day) compared with the late group (19.0 ± 2.8%/day, P < 0.02). The fractional and absolute synthesis rates of albumin were similar in the two groups, 6.4 ± 1.5 vs. 6.5 ± 1.0%/day and 97 ± 19 vs. 96 ± 18 mg · kg-1 · day-1 for the early and late groups, respectively. It is concluded that laparoscopic surgery was accompanied by a decrease in total liver protein synthesis rate, which developed rapidly during surgery. In contrast, no change in the synthesis rate of albumin was apparent during the course of surgery.

laparoscopy; stable isotope; surgical trauma


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