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Gas embolism in laparoscopic hepatectomy: what is the optimal pneumoperitoneal pressure for laparoscopic major hepatectomy?

  • Topics
  • Laparoscopic major liver resection
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Laparoscopic hepatectomy (LH) has become popular as a surgical treatment for liver diseases, and numerous recent studies indicate that it is safe and has advantages in selected patients. Because of the magnified view offered by the laparoscope under pneumoperitoneal pressure, LH results in less bleeding than open laparotomy. However, gas embolism is an important concern that has been discussed in the literature, and experimental studies have shown that LH is associated with a high incidence of gas embolism. Major hepatectomies are done laparoscopically in some centers, even though the risk of gas embolism is believed to be higher than for minor hepatectomy due to the wide transection plane with dissection of major hepatic veins and long operative time. At many high-volume centers, LH is performed at a pneumoperitoneal pressure less than 12 mmHg, and reports indicate that the rate of clinically severe gas embolism is low. However, more studies will be necessary to elucidate the optimal pneumoperitoneal pressure and the incidence of gas embolism during LH.

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Authors and Affiliations

  1. Department of Surgery, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan

    Yuichiro Otsuka, Toshio Katagiri, Jun Ishii, Tetsuya Maeda, Yoshihisa Kubota, Akira Tamura, Masaru Tsuchiya & Hironori Kaneko

Authors
  1. Yuichiro Otsuka
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  2. Toshio Katagiri
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  3. Jun Ishii
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  4. Tetsuya Maeda
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  5. Yoshihisa Kubota
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  6. Akira Tamura
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  7. Masaru Tsuchiya
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  8. Hironori Kaneko
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Correspondence to Hironori Kaneko.

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Otsuka, Y., Katagiri, T., Ishii, J. et al. Gas embolism in laparoscopic hepatectomy: what is the optimal pneumoperitoneal pressure for laparoscopic major hepatectomy?. J Hepatobiliary Pancreat Sci 20, 137–140 (2013). https://doi.org/10.1007/s00534-012-0556-0

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  • DOI: https://doi.org/10.1007/s00534-012-0556-0

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