PMID: 9553242Apr 29, 1998Paper

Hypovolemic shock induced by laparoscopic cholecystectomy--a case report

Acta anaesthesiologica Sinica
Y H TsengW T Hung

Abstract

Since its introduction and development in the 1960s, laparoscopic cholecystectomy has become widely accepted by the medical community and the public as the treatment of choice for various gallbladder disorders. We present a 46-year-old male who underwent laparoscopic cholecystectomy, during which inadvertent penetration of the first trocar resulted in injury of the abdominal aorta and then hypovolemic shock ensured. The time from notification of shock by the anesthesiologist to switch of procedure to exploratory laparotomy for stanching hemorrhage was twenty minutes. During the intervention, blood loss was over 3,000 ml and despite rapid infusion of plasma expander, blood pressure could only be maintained between 40/18 to 60/20 mmHg. After the patient became stabilized and blood pressure was elevated to acceptable levels, conventional cholecystectomy was performed instead. Perioperative blood loss of 7,300 ml was estimated. In total, the patient received 24 units of packed red blood cells, 12 units of fresh frozen plasma, and 12 units of platelets. After the operation, the patient was transferred to the surgical ICU for further observation. For 24 h at the ICU, blood pressure remained unstable, urine output decreased gradually,...Continue Reading

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