Common peroneal nerve palsy: an unexpected complication of liver surgery

Common peroneal nerve palsy is a well-recognized complication following surgery in lithotomy position, particularly colorectal and gynecologic surgery. But it is quite rare after liver surgery because patients are usually placed in supine position.

There were three cases of common peroneal nerve palsy after liver surgery in the past 2 years, including two cases of liver transplantation and one case of extended right hepatectomy. Two cases were bilateral and one case was unilateral. They were placed in supine position and the mean operative time was 8 hours. Patients complained symptom of foot drop within 1 week after operation. Electromyographic examinations showed evidence compatible with common peroneal nerve palsy. All of them improved with conservative treatment within 6 months.

Common peroneal nerve palsy may develop after liver surgery even in supine position. Injury to common peroneal nerve should be a concern before and during the operation. This complication could be managed conservatively with an uneventful result.