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Argon gas embolism in the application of laparoscopic microwave coagulation therapy

  • Case report of interest
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background

A major concern in the use of the argon beam coagulator system is the potential risk of argon gas embolism.

Methods

Seven cases with argon gas embolism in the English literature were reviewed along with the current case. The latter case was a 77-year-old female having laparoscopic hepatectomy after application of the microwave coagulation system on the cutting planes.

Results

Immediately following shots of an argon beam to control local bleeding at the needle hole in the liver caused by microwave coagulation, the end-tidal carbon disappeared, followed by cardiovascular collapse. After 18 min of cardiovascular resuscitation, the tumors were resected under laparotomy.

Conclusions

After reviewing the cases, pneumoperitoneum (57.1%), hepatic needle punctures (42.8%) and direct application of the argon beam to the liver (28.6%) can be considered as risky processes in such events. Caution is necessary in the use of an argon beam in liver surgery to avoid life-threatening gas embolism.

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Abbreviations

ABC:

Argon beam coagulator

HCC:

Hepatocellular carcinoma

LC:

Liver cirrhosis

Lap:

Laparoscope

MCT:

Microwave coagulation therapy

N/A:

Not available

PTLD:

Post-transplant lymphoproliferative disorders

s/p LTx:

State of post liver transplantation

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Authors and Affiliations

  1. Department of Surgery, The University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan

    Toru Ikegami, Mitsuo Shimada, Satoru Imura, Yuji Morine, Hirofumi Kanemura & Jun Hanaoka

  2. Department of Anesthesiology, The University of Tokushima, Tokushima, 770-8503, Japan

    Tomoka Nakamura & Shinji Kawahito

Authors
  1. Toru Ikegami
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  2. Mitsuo Shimada
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  3. Satoru Imura
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  4. Tomoka Nakamura
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  5. Shinji Kawahito
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  6. Yuji Morine
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  7. Hirofumi Kanemura
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  8. Jun Hanaoka
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Corresponding author

Correspondence to Toru Ikegami.

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Ikegami, T., Shimada, M., Imura, S. et al. Argon gas embolism in the application of laparoscopic microwave coagulation therapy. J Hepatobiliary Pancreat Surg 16, 394–398 (2009). https://doi.org/10.1007/s00534-008-0039-5

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  • DOI: https://doi.org/10.1007/s00534-008-0039-5

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