Carbon Dioxide Embolism with Hypertension During Laparoscopic Hepatectomy

Abstract

Laparoscopic hepatectomy is a commonly used technique to surgically resect the liver. However, carbon dioxide embolism can be a rare and fatal complication. A 54-year-old man was undergoing a laparoscopic hepatectomy when an arterial puncture occurred. An increase in ETCO₂ from 34 mmHg to 88 mmHg was noted along with a concomitant increase in blood pressure from 110/70 mmHg to 141/85 mmHg. This is unique because carbon dioxide embolism usually presents with hypotension. To quickly stabilize the patient, pneumoperitoneum pressure was immediately reduced, Pringle maneuver was performed, and minute ventilation was increased. The patient was safely extubated with no post-operative complications.