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Published in: Obesity Surgery 7/2009

01-07-2009 | Research Article

Inflammatory Response Measured By Body Temperature, C-Reactive Protein and White Blood Cell Count 1, 3, and 5 Days After Laparotomic or Laparoscopic Gastric Bypass Surgery

Authors: Attila Csendes, Ana Maria Burgos, Daniel Roizblatt, Claudio Garay, Pablo Bezama

Published in: Obesity Surgery | Issue 7/2009

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Abstract

Background

Morbid obesity is a chronic inflammatory condition due to the production of several cytokines from the adipose tissue. However, what happens with some of these parameters the first days after surgery is unknown. Therefore, the objective of the present study was to determine, through a prospective and descriptive study, the behavior of the C-reactive protein (CRP), the white blood cell count, and the body temperature prior to a gastric bypass and for 5 days afterwards.

Methods

A total of 156 patients with morbid obesity were included in this prospective study. There were 120 women and 36 men, with a mean age of 41 years and a body mass index of 43 kg/m2. They were submitted either to a laparotomic resectional gastric bypass or to a laparoscopic gastric bypass. Body temperature was measured every 8 h during 5 days. CPR and white blood cells were measured at the first, third, and fifth day after surgery.

Results

All patients had a normal postoperative course. Body temperature showed no change. White blood cells increased significantly at the first and third day after surgery but normalized by the fifth day. However, the third day after surgery, laparotomic gastric bypass patients showed a significantly greater increase in the total white blood cell count as well as in segmented neutrophil cells compared to laparoscopic surgery patients. CRP exhibited a similar increase and was more pronounced after a laparotomic approach.

Conclusion

During the 5 days after gastric bypass, a significant increase in white blood cells and CRP was observed. The increase was significantly greater after a laparotomic bypass compared to the laparoscopic approach.
Literature
1.
go back to reference Tillett WM, Francis T. Serological reactions in pneumonia with a non protein somatic fraction of pneumococcus. J Exp Med. 1930;52:561–71.CrossRef Tillett WM, Francis T. Serological reactions in pneumonia with a non protein somatic fraction of pneumococcus. J Exp Med. 1930;52:561–71.CrossRef
2.
go back to reference Larsson S, Thelander U, Friberg S. C-reactive protein levels after elective orthopaedic surgery. Clin Orthop. 1992;275:237–41. Larsson S, Thelander U, Friberg S. C-reactive protein levels after elective orthopaedic surgery. Clin Orthop. 1992;275:237–41.
3.
go back to reference Blomqvist L, Malm M, Berg A, et al. The inflammatory reaction in elective flap surgery. Plast Reconstr Surg. 1998;101:1524–8.CrossRef Blomqvist L, Malm M, Berg A, et al. The inflammatory reaction in elective flap surgery. Plast Reconstr Surg. 1998;101:1524–8.CrossRef
4.
go back to reference Hanusch-Enserer U, Cauza E, Spak M, et al. Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding. Int J Obes Relt Metab Disord. 2003;27:355–61.CrossRef Hanusch-Enserer U, Cauza E, Spak M, et al. Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding. Int J Obes Relt Metab Disord. 2003;27:355–61.CrossRef
5.
go back to reference Csendes A, Burdiles P, Papapietro K, et al. Results of gastric bypass plus resection of the distal excluded gastric segment in patients with morbid obesity. J Gastrointest Surg. 2005;9:121–31.CrossRef Csendes A, Burdiles P, Papapietro K, et al. Results of gastric bypass plus resection of the distal excluded gastric segment in patients with morbid obesity. J Gastrointest Surg. 2005;9:121–31.CrossRef
6.
go back to reference Schauer P, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.CrossRef Schauer P, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.CrossRef
7.
go back to reference Nanji AA, Freemon JD. Relationship between body weight and total leucocyte count in morbid obesity. Am J Clin Pathol. 1985;84:346–7.CrossRef Nanji AA, Freemon JD. Relationship between body weight and total leucocyte count in morbid obesity. Am J Clin Pathol. 1985;84:346–7.CrossRef
8.
go back to reference Ford ES. Body mass index, diabetes and C-reactive protein among US adults. Diabetes Care. 1999;22:1971–7.CrossRef Ford ES. Body mass index, diabetes and C-reactive protein among US adults. Diabetes Care. 1999;22:1971–7.CrossRef
9.
go back to reference Schwartz J, Weiss ST. Host and environmental factors influencing the peripheral blood leukocyte count. Am J Epidem. 1991;134:1402–9.CrossRef Schwartz J, Weiss ST. Host and environmental factors influencing the peripheral blood leukocyte count. Am J Epidem. 1991;134:1402–9.CrossRef
10.
go back to reference Herishanu Y, Ragowski O, Polliack A, et al. Leukocytosis in obese individuals: possible link in patients with unexplained persistent neutrophilia. Europ J Haemat. 2006;76:516–20.CrossRef Herishanu Y, Ragowski O, Polliack A, et al. Leukocytosis in obese individuals: possible link in patients with unexplained persistent neutrophilia. Europ J Haemat. 2006;76:516–20.CrossRef
11.
12.
go back to reference Wise BE. The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked obesity. J Am Soc Nephol. 2004;15:2792–800.CrossRef Wise BE. The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked obesity. J Am Soc Nephol. 2004;15:2792–800.CrossRef
13.
go back to reference Fantuzzi G. Adipose tissue, adipokines and inflammation. J Allergy Clin Inmunol. 2005;115:911–9.CrossRef Fantuzzi G. Adipose tissue, adipokines and inflammation. J Allergy Clin Inmunol. 2005;115:911–9.CrossRef
14.
go back to reference Khaodhiar L, Ling PR, Blackburn GL, et al. Serum levels of interleukin-6 and C-reactive protein correlate with body mass index across the broad range of obesity. J Parent Ent Nutr. 2004;28:410–5.CrossRef Khaodhiar L, Ling PR, Blackburn GL, et al. Serum levels of interleukin-6 and C-reactive protein correlate with body mass index across the broad range of obesity. J Parent Ent Nutr. 2004;28:410–5.CrossRef
15.
go back to reference Dixon JB, O’Brien PE. Obesity and the white blood cells count: changes with sustained weight loss. Obes Surg. 2006;16:251–7.CrossRef Dixon JB, O’Brien PE. Obesity and the white blood cells count: changes with sustained weight loss. Obes Surg. 2006;16:251–7.CrossRef
16.
go back to reference Emery CF, Fondow MDM, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg. 2007;17:759–63.CrossRef Emery CF, Fondow MDM, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg. 2007;17:759–63.CrossRef
17.
go back to reference Orrego M, Perez M, Perez MS, et al. Plasmatic values of C-reactive protein in elective orthopaedic surgery. Rev Méd Chile. 2005;133:1341–8.CrossRef Orrego M, Perez M, Perez MS, et al. Plasmatic values of C-reactive protein in elective orthopaedic surgery. Rev Méd Chile. 2005;133:1341–8.CrossRef
18.
go back to reference Faintuch J, Horie LM, Barbeiro HV, et al. Systemic inflammation in morbidly obese subjects: response to oral supplementation with alpha-linolenic acid. Obes Surg. 2007;17:341–7.CrossRef Faintuch J, Horie LM, Barbeiro HV, et al. Systemic inflammation in morbidly obese subjects: response to oral supplementation with alpha-linolenic acid. Obes Surg. 2007;17:341–7.CrossRef
Metadata
Title
Inflammatory Response Measured By Body Temperature, C-Reactive Protein and White Blood Cell Count 1, 3, and 5 Days After Laparotomic or Laparoscopic Gastric Bypass Surgery
Authors
Attila Csendes
Ana Maria Burgos
Daniel Roizblatt
Claudio Garay
Pablo Bezama
Publication date
01-07-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 7/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9702-9

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