Abstract
Advances in surgical technique and perioperative and perinatal management of congenital heart disease have decreased the mortality in patients. These patients grow to adulthood and commonly undergo noncardiac surgery. On the other hand, advances in laparoscopic surgery have decreased length of hospitalization and reduced postoperative pain. This surgical technique has become the prefered approach ; however laparoscopic surgery induces hemodynamic changes and rarely induces gas embolism.
We report a case of abdominal wall lift laparoscopic cholecystectomy in a patient with right-to-left shunt associated with Ebstein's Anomaly. A 46-year-old women with Ebstein's Anomaly had a brain abscess and was treated with a drainage procedure. During this treatment, she experienced two gallstone attacks.
She had cyanosis from Ebstein's Anomaly, so she was refered to our hospital.
Cardiac catheterization and transesophageal echocardiography showed a right-to-left shunt from an atrial septal defect.
So, she was scheduled for an abdominal wall lift cholecystectomy because of her cardiac problem. Surgery and anesthesia were perfomed without any serious complication.
For patients with congenital heart disease who need laparoscopic surgery it would be better to avoid pheumoperitoneum laparoscopy, and to perform an abdominal wall lift laparoscopy.
