The effect of laparoscopic cholecystectomy on insulin sensitivity.

It is well known that there is impaired glucose tolerance after open abdominal surgery. We have investigated the effect on insulin sensitivity of laparoscopic cholecystectomy. Eight non-diabetic patients aged 51 +/- 3.5 years were studied pre and postoperatively. Insulin sensitivity measured by the short insulin tolerance test (ITT) was expressed as % disappearance of glucose per minute (KITT). Preoperative fasting blood glucose was 4.7 +/- 0.15 mmol/l compared with postoperative fasting blood glucose of 5.7 +/- 0.31 mmol/l (p = 0.02). Fasting insulin levels were 8.4 +/- 1.6 mU/l preoperatively compared to 30.0 +/- 9.3 mU/l postoperatively (p = 0.1 NS). KITT was 2.29 +/- 0.2% min-1 (range 1.0-3.03) preoperatively with 1.11 +/- 0.25% min-1 (range 0.13-1.97) postoperatively (p = 0.02). Hence marked insulin resistance is a consequence of major abdominal surgery irrespective of surgical technique.