The causes and management of carbon dioxide embolism in laparoscopic hepatectomy

Objective To investigate the strategies in dealing with intraoperative CO2 embolizm during Laparoscopic hepatectomy (LH). Methods We collected and analyzed data from patients who underwent laparoscopic hepatectomy (LH) in our hospital from Jan. 2013 to Aug. 2017. There were 321 patients. The criteria for the diagnosis of CO2 embolism were rapid intraoperative decrease in PetCO2 and SPO2 accompanied with tachyarrhythmia. Results 12 patients were diagnosed to have CO2 embolism. The rate was 3.7%. For these 12 patients, 10 patients were dealt with laparoscopically and 2 patients were converted to open surgery. Conclusion CO2 embolism did not rarely occur in LH patients. Sophisticated operations and careful manipulation in LH are the only ways to prevent CO2 embolism. Key words: Laparoscopic hepatectomy; CO2 embolus; Pressure of end-tidal carbon dioxide; Oxygen saturation