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Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach

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Delayed recovery following laparoscopic partial hepatectomy.

Viola Van Gorp¹, Marc Diltoer, Georges Delvaux

¹Department of Critical Care, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels, Belgium. viola.vangorp@hotmail.com

European Journal of Anaesthesiology

|September 28, 2011

Summary

A patient experienced coma after surgery due to a paradoxical carbon dioxide embolism caused by a patent foramen ovale. Prompt diagnosis and intensive care led to her near-complete recovery.

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Area of Science:

Neurology
Cardiology
Surgical Oncology

Background:

Laparoscopic partial hepatectomy is a common surgical procedure.
Complications can arise, including neurological events.
Patent foramen ovale (PFO) is a potential risk factor for paradoxical emboli.

Observation:

A 42-year-old woman developed unexpected coma post-laparoscopic partial hepatectomy.
Cerebral ischemic lesions were identified on MRI.
A patent foramen ovale was discovered during further investigations.

Findings:

The patient was diagnosed with cryptogenic stroke.
The stroke was attributed to a paradoxical carbon dioxide embolism.
This occurred during the surgical procedure.

Implications:

This case highlights the risk of paradoxical carbon dioxide embolism in patients with PFO undergoing laparoscopic surgery.
Early diagnosis and intensive care are crucial for favorable outcomes.
Management strategies for perioperative stroke and paradoxical emboli require careful consideration.