Kang Hyeryung, Park Joohyun, Lee Jeong Jin, Kim Gaab-Soo
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2018 Aug;71(4):323-327. doi: 10.4097/kja.d.18.27211. Epub 2018 Apr 25.
Intraoperative hypothermia occurs frequently, but hyperthermia is relatively rare during general anesthesia. We experienced a case of hyperthermia during living donor liver transplantation that appeared to be significantly associated with biliary obstruction. A 65-year-old male patient was diagnosed with intrahepatic cholangiocarcinoma, and living donor liver transplantation was planned after confirmation of no metastasis via intraoperative frozen biopsy. Following resection of a segment of common bile duct for frozen biopsy, the surgeon clamped the common bile duct, and the patient's body temperature increased gradually to 39.5°C. As the congested bile was drained, the body temperature decreased to the normal range. This case report suggests that when a patient develops unexplained hyperthermia during hepatobiliary surgery or in a chance of biliary obstruction, clinicians should consider bile congestion as a possible reason for hyperthermia.
术中低体温很常见，但全身麻醉期间高热相对少见。我们遇到一例活体肝移植术中高热病例，该高热似乎与胆道梗阻显著相关。一名65岁男性患者被诊断为肝内胆管癌，经术中冰冻活检确认无转移后计划进行活体肝移植。在切除一段胆总管进行冰冻活检后，外科医生夹住胆总管，患者体温逐渐升至39.5°C。随着充血胆汁的引流，体温降至正常范围。本病例报告提示，当患者在肝胆手术期间出现不明原因的高热或有胆道梗阻可能时，临床医生应考虑胆汁淤积是高热的可能原因。
