OKTAY AYDIN, Faruk PEHLİVANLI, Gökhan KARACA, Çağatay DAPHAN, KUZEY AYDINURAZ, akan BOYUNAĞA, Salim NESELİOGLU, Özcan EREL

KOLESİSTEKTOMİ PLANLANAN HASTALARDA KOLELİTİYAZİSİN VE KOLESİSTEKTOMİNİN TİYOL/DİSÜLFİD DENGESİ'NE ETKİSİ

Amaç: Bu prospektif kontrollu klinik çalışmanın amacı yetişkinlerde komplike olmamış kolelitiyazisin ve buna yönelik uygulanan laparoskopik kolesistektomi ameliyatının hastalarda tiyol/disülfid dengesine etkilerini araştırmaktır.Gereç ve Yöntem: Çalışmaya 18-80 yaş arası sağlıklı gönüllü katılımcılar (Kontrol grubu, n=30) ve 18-80 yaş arasında semptomatik safra taşı tanısı konulup laparoskopik kolesistektomi planlanan hastalar (KLS grubu, n=30) alındı. Çalışmada sağlıklı gönüllülerden bir defaya mahsus ve tüm hastalardan ameliyattan 1 saat önce ve ameliyattan 24 saat sonra iki kez olmak üzere 2 mL venöz kan örnekleri alındı ve serumlarda tiyol/disülfid düzeyleri incelendi.Bulgular: Çalışmanın sonunda Kontrol grubunun Nativ Tiyol, Total Tiyol ve Disülfid değerleri KLS grubunun ameliyat öncesi ölçülen değerlerine göre daha yüksek bulundu (p<0.001). KLS grubuna ait ameliyat sonrası bakılan Nativ Tiyol, Total Tiyol ve Disülfid değerlerinin Kontrol grubuna göre düşük olduğu tespit edildi (p<0.001). Ayrıca Kontrol grubunda Disülfid/Nativ Tiyol ve Disülfid/Total Tiyol oranları KLS grubu ameliyat sonrası değerlerine kıyasla daha yüksek ve Nativ Tiyol/Total Tiyol oranı daha düşük olarak ölçüldü. Diğer yandan KLS grubunun ameliyat öncesi ve ameliyat sonrası laboratuvar değerleri arasında da farlılık olmadığı görüldü. Sonuç: Bu sonuçlarla kolelitiyazis hasta grubunda hem ameliyat öncesi hem de ameliyat sonrası doğal tiyol, toplam tiyol, disülfid seviyelerinin düşük olması kolelitiyazis kaynaklı oksidatif stres nedeniyle bu bileşiklerin bu hastalarda tüketildiğini düşündürdü. Diğer yandan bu hastalarda oksidatif metabolizmada olan bu değişikliklerin safra kesesinde taş oluşumunu provake edebileceği de düşünüldü.

Anahtar Kelimeler:

Kolelitiyazis, kolesistektomi, tiyol/disülfid dengesi

The Effect of Cholelithiasis and Cholecystectomy on Thiol/Disulfide Homeostasis in Patients Undergoing Cholecystectomy

Objective: The aim of this prospective controlled clinical research study is to investigate the effects of noncomplicated cholelithiasis and laparoscopic cholecystectomy surgery for cholelithiasis in adults on thiol/disulfide balance. Material and Method: The study included healthy volunteers aged 18-80 years (Control group, n=30) and patients with symptomatic gallstones between 18-80 years of age who underwent laparoscopic cholecystectomy (KLS group, n=30). In this study, 2 mL venous blood samples were taken from healthy volunteers for only one time, 1 hour before the operation and 24 hours after the operation from all patients, and thiol/disulfide levels in the serum were examined.Results: At the end of the study, Native Thiol, Total Thiol and Disulfide values of the control group were higher than the preoperative values of the KLS group (p<0.001). The postoperative values of Native Thiol, Total Thiol and Disulfide in the KLS group was found to be lower than the control group (p<0.001). Also in the control group, Disulfide/Native Thiol and Disulfide/Total Thiol ratios were higher than the postoperative values of KLS group and Native Thiol/Total Thiol ratio was measured lower. On the otherhand, there was no difference between the preoperative and postoperative laboratory values of the KLS group. Conclusion: These results suggest that both the pre-operative and post-operative native thiol, total thiol, and disulfide levels were lower in the cholelithiasis patient group because they were consumed in these patients due to the oxidative stres caused by cholelithiasis. On the otherhand, these changes in oxidative metabolism in these patients were thought to provoke stone formation in gallbladder.

Keywords:

Cholelithiasis, cholecystectomy, thiol/disulfide homeostasis,

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