Abstract
We investigated 95 cases who underwent laparoscopic guided cholecystectomy (LGC) regarding operation time, anesthesia time, PET CO2, PaCO2, pH and perioperative complications in comparison to those in open cholecystectomy. Furthermore, transeso-phageal echocardiography (TEE) was employed to detect gas emboli in the right atrium in 26 patients during laparoscopy.
PET CO2, PaCO2 and pH changed significantly 30 minutes after pneumoperitoneum was established. More cardiovascular instability and complications, such as subcutaneous emphysema, were observed in LGC than in open laparotomy. Abnormal gas shadows which were suspected venous gas emboli were detected by TEE in eleven cases (42.3%). Besides cardiovascular instability (side effect) and hypercapnia during laparoscopy, gas embolism caused by carbon dioxide should be considered as a serious complication during anesthesia of LGC.
