Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	146
Country	Italy

Received	2012-08-05 02:05
Peer-Review Started
To Make the First Decision
Return for Revision
Revised
Second Decision	2013-02-06 09:30
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2013-02-06 11:16
Articles in Press
Publication Fee Transferred
Edit the Manuscript by Language Editor	2013-03-05 02:39
Typeset the Manuscript	2013-04-08 17:29
Publish the Manuscript Online	2013-04-24 09:11

ISSN	1948-9366 (online)
Open Access
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Category	Surgery
Manuscript Type	Autobiography
Article Title	Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis
Manuscript Source	Invited Manuscript
All Author List	Federico Sista, Mario Schietroma, Giuseppe De Santis, Antonella Mattei, Emanuela Marina Cecilia, Federica Piccione, Sergio Leardi, Francesco Carlei and Gianfranco Amicucci
Funding Agency and Grant Number
Corresponding Author	Federico Sista, MD, Department of Surgery, University of L’Aquila, Piazza Rivera, 1, 67100 Coppito, Italy. silversista@gmail.com
Key Words	Systemic inflammation; Immune response; Laparoscopy; Cholecystectomy; Bile peritonitis
Core Tip	Laparoscopic techniques are being increasingly used in diffuse or localised peritonitis. However, a possible concern is that increased intra-abdominal pressure may promote bacteraemia and the systemic inflammatory response during laparoscopic surgery. The majority of reports in the literature are on experimental studies made using animal models. This study, instead, is a prospective randomized study conducted on human subjects. Experimental studies on peritonitis showed that the inflammatory response was significantly higher in the open cholecystectomy (OC) group than in the laparoscopic cholecystectomy (LC) group in the animal models, suggesting that carbon dioxide pneumoperitoneum has a protective effect against bacterial peritonitis. This study, in contrast to the previous ones, is the first work demonstrating that OC after biliary peritonitis increases the incidence of bacteraemia, endotoxaemia and systemic inflammation, compared with the LC group. The authors also demonstrated that early enhanced post-operative systemic inflammation may cause lower transient immunologic defense after laparotomy (decrease of human leukocyte antigen-DR), leading to increased sepsis in these patients.
Publish Date	2013-04-24 09:11
Citation	Sista F, Schietroma M, De Santis G, Mattei A, Cecilia EM, Piccione F, Leardi S, Carlei F, Amicucci G. Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis. World J Gastrointest Surg 2013; 5(4): 73-82
URL	http://www.wjgnet.com/1948-9366/full/v5/i4/73.htm
DOI	http://dx.doi.org/10.4240/wjgs.v5.i4.73

Full Article (PDF)	WJGS-5-73.pdf
Manuscript File	146-Review.docx
Answering Reviewers	146-Answering reviewers.PDF
Copyright License Agreement	146-Copyright assignment.PDF
Peer-review Report	146-Peer review(s).docx
Scientific Editor Work List	146-Scientific editor work list.doc