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支气管胸膜瘘患者的胆囊切除术——麻醉医生如履薄冰。

Cholecystectomy in a patient with Broncho pleural fistula - An Anesthesiologist's tight rope walk.

作者信息

Tharsis Reshma P, Thalepaddy Megha, Kaasat Ankita

机构信息

Department of Anesthesiology, KMC Manipal, Manipal Academy of Higher Education, Udupi, Karnataka, India.

出版信息

Saudi J Anaesth. 2023 Apr-Jun;17(2):260-262. doi: 10.4103/sja.sja_667_22. Epub 2023 Mar 10.

Abstract

Patients presenting for surgery postlobectomy with Broncho pleural fistula are prone for perioperative respiratory complications and pose a significant challenge to anesthetist. Published data to guide perioperative management of such cases especially for abdominal surgeries are scarce. We describe a 51-year-old gentleman status postlobectomy with Broncho pleural fistula posted for cholecystectomy in view of symptomatic gallstones. Laparoscopic surgery was later converted to open surgery in view of surgical difficulties. Perioperative period was uneventful and proper modes of analgesia helped in faster recovery. Proper understanding of physiological and anatomical changes and proper planning of anesthesia facilitated safe and uneventful anesthesia.

摘要

接受肺叶切除术后合并支气管胸膜瘘的患者进行手术时易发生围手术期呼吸并发症,给麻醉医生带来重大挑战。指导此类病例尤其是腹部手术围手术期管理的已发表数据很少。我们描述了一位51岁男性,因有症状的胆结石接受胆囊切除术,其为肺叶切除术后合并支气管胸膜瘘。鉴于手术困难,腹腔镜手术后来改为开放手术。围手术期过程顺利,适当的镇痛方式有助于更快康复。对生理和解剖变化的正确理解以及合理的麻醉计划有助于实现安全、平稳的麻醉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5570/10228872/bfb2948720fd/SJA-17-260-g001.jpg

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