CARBON-DIOXIDE EMBOLIZATION AND LAPAROSCOPIC CHOLECYSTECTOMY

The risk of venous air or CO2 embolization during laparoscopic biliary procedures is unknown. Sixty-one consecutive patients undergoing lapa roscopic cholecystectomy at La Crosse Lutheran Hospital/Gundersen Clin ic were monitored by precordial Doppler ultrasound and end-tidal capno graphy to determine the risk of gas embolization. Patients ranged in a ge from 19 to 77 years (mean, 47 years). No venous embolization was de tected by Doppler ultrasound or capnography. The highest end-tidal CO2 ranged from 34 to 53 mm Hg (mean, 41 mm Hg). No patient demonstrated an abrupt change in end-tidal CO2. No significant intraoperative hemod ynamic changes occurred, and no postoperative neurologic defects devel oped. We caution the surgical community to remain alert concerning the possibility of venous gas embolization as newer laparoscopic procedur es are developed that may have increased risks of embolization.