| Objective:To study whether the elderly patients'post-operative stress response and fatigue syndrome can be eased by laparoscopic cholecystectomy,trying to offer objective proof for the superiority of laparoscopic cholecystectomy in curing the elderly patients with gallbladder stone.Methods:In the beginning, forty elderly male and female gallbladder stone patients, aging from 60 to 70, have been under screening in terms of relevant indication. Then the selected patients were divided into 2 groups, and 20 patients with no significant differences of gender and no age in each group. The two groups were named as laparoscopic cholecystectomy operation group (L.C) and open–cholecystectomy operation group (O.C). Next, the day before the operation was marked T0, the first day after operation T1, the second day after operation T2, the third day after operation T3 . T0, T1, T2, T3 were chosen as the observation points. Later, various indicators, both in pre-operation and post-operation, were examined, such as Interleukin-6 (IL-6), Interleukin-10(IL-10), C-reactive protein (CRP), white blood cell (WBC), Neutropils and Cortisol etc. At last, from the observation points T1, T2, T3 , some analysis were made, such as assessing the patients'post-operation fatigue, counting and comparing the two groups'average operation time, operation blood loss amount, post-operation analgesic using rate, the post-operation fever days, and the average length of hospitalization.Results:1. In pre-operation, there was no significant IL-6 density level distinction between the two groups. In post-operation, a significant IL-6 density level increase was detected in the two groups. And some significant IL-6 levels distinctions were revealed when compared with that of T0. Besides, IL-6 level reaches its peak in the T1 , then gradually declines in the T2 and T3 . In the T1 and T2 , in terms of IL-6 density levels, L.C's were lower than O.C's .2. In pre-operation, there was no significant IL-10 density distinction between the two group's patients. In post-operation, from T1, the IL-10 density of patients in two groups begins to decline; IL-10 densities of the patients in L.C were at the lowest level in the T2 and show a striking difference from O.C group. In addition, IL-10 densities in the T1 and T3 were lower than that of pre-operation; By contrast, for the O.C IL-10 density levels of the patients were at the lowest level in the T3 after some declining in the T1 and T2. Comparing the two groups, in the T2 and T3 L.C's IL-10 density levels were significantly higher than O.C's.3. In pre-operation, there was no significant CRP density distinction between the two group's patients; in the different post-operation periods, CRP levels in both the two groups'patients rise and reach its peak in the T1.Meanwhile, CRP density levels in O.C were significantly higher than those of LC. Besides, in the T3CRP levels of O.C were significantly higher than that of pre-operation. By contrast, in the T3, CRP level of patients in the L.C has already restored to the normal level. Comparing the two groups, in post-operation L.C's CRP density levels were significantly lower than O.C's.4. In pre-operation, there was no significant distinction about WBC number, neutrophil category between the two group's patients. In post-operation, WBC number of patients in the O.C group increases in the T1, T2, T3 and reaches its peak in the T1, By contrast, in the T1 and T2 the increasing WBC number of patients in L.C is detected, and it approaches to the normal level in the T3. Comparing the two groups, O.C's WBC number of patients reveals a more significant increase than L.C's in post-operation periods. 5. In pre-operation, there was no significant distinction about cortisol densities between the two group's patients. In post-operation, in terms of cortisol densities of the patients, no obvious increase in the T1, T2, T3 was revealed in L.C group, and no significant difference from that of T0 was presented. In post-operation cortisol densities of the patients in O.C increase in the T1 before they restore to the normal in the T2 , showing the significant differences from that of T0 . Comparing the two groups, in the T2 cortisol densities of the L.C patients were lower than O.C group's. 6. In terms of post-operation fatigue syndrome levels of the two groups'patient, an increase in both the two groups was detected, and they both reach the peak in the T1 .Comparing the two groups, the O.C's post-operation fatigue syndrome levels were higher than L.C's.Conclusion:In curing the elderly patients with gallbladder stone, compared with open–cholecystectomy, post-operative stress response and fatigue syndrome in the elderly patients can be satisfactorily eased by laparoscopic cholecystectomy. So it's safe to conclude that the clinical value of laparoscopic cholecystectomy is reliable and significant.
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