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

Year 2019, , 95 - 101, 30.04.2019

Oktay Aydın , Faruk Pehlivanlı , Gökhan Karaca , Çağatay Erden Daphan , Kuzey Aydınuraz Hakan Boyunağa Salim Neşelioğlu Özcan Erel

https://doi.org/10.24938/kutfd.531638

Abstract

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.

Keywords

Kolelitiyazis, kolesistektomi, tiyol/disülfid dengesi

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

Abstract

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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