Treatment of CO2 embolism in laparoscopic hepatectomy

VernacularTitle:腹腔镜肝切除术中严重CO2栓塞的处理
Author: Baoqiang WU ¹ ; Zhen QU ; Jun HU ; Wensong LIU ; Yong JIANG ; Donglin SUN
Author Information

1. 苏州大学附属第三医院常州市第一人民医院肝胆胰外科
Keywords: Laparoscopic hepatectomy; CO2 embolism; Transesophageal echocardiograph
From: Chinese Journal of Hepatobiliary Surgery 2018;24(8):518-521
CountryChina
Language:Chinese
Abstract: Objective To study the diagnosis and treatment of CO2 embolism in laparoscopic hepatectomy (LH).Methods A retrospective study was conducted on 80 patients who underwent various types of LH from June 2016 to November 2017.The clinical data of 4 patients who suffered from severe CO2 embolism were analyzed.Results The operation time of 80 patients varied from 65 min to 345 min (average 170 min).Tbe amount of blood loss ranged from 50 ml to 2 500 ml (average 450 ml).28 patients (35％) required blood transfusion.Two patients were converted to open operation because of uncontrollable bleeding.Four patients suffered from severe CO2 embolism with significant changes in circulation and respiration.After active and effective treatment,none required open conversion and all recovered well.Conclusions Any sudden respiratory and circulatory changes during LH should lead us to think of severe CO2 embolism.Timely and effective treatment could convert a dangerous situation to become safe.