Laparoscopic-After billiard surgery-Acute lung injury

A case of acute lung injury after laparoscopic biliary surgery was reported. The 56-year-old male patient underwent laparoscopic cholecystectomy and choledocholithotomy under general anesthesia. He showed severe hypoxemia after the operation, and was resuscitated after 3 days of non-invasive BiPAP respiratory support and anti-inflammatory treatment. According to the features of significant hypoxemia without notable respiratory distress manifestation, severe infiltration in the lung, and attenuated breath sounds without obvious wet or dry rales, the diagnosis of a low pressure interstitial pulmonary edema was suggested. The pathogenesis may be due to the pulmonary capillary endothelial damage and increased permeability, thus both of water and plasma protein leaked into the lung interstitial. It should be noticed that the amino acid oxidase in hemocoagnlase could also induce acute lung injury. Key words: Laparoscopic;  Billiard tract surgery;  Acute lung injury