title: Laparoscopic cholecystectomy performed under regional anesthesia in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Laparoscopic cholecystectomy has been successfully performed using epidural anesthesia. We evaluated our experience with this surgical approach in high-risk patients.
  
  
  METHODS
  We present the results of 29 patients with gallstones who, between 1998 and 1999, underwent laparoscopic cholecystectomy with epidural anesthesia. All but 1 patient had chronic obstructive pulmonary disease.
  
  
  RESULTS
  All 29 surgeries were successfully completed via laparoscopy and with the patients under epidural anesthesia. No patient required endotracheal intubation during surgery or pain medication afterward. Postoperatively, 1 patient developed a wound infection and 3 patients developed urinary retention. At last follow-up (12 months postop), all patients were in good health.
  
  
  CONCLUSIONS
  In this series, laparoscopic cholecystectomy was feasible under epidural anesthesia and it eliminated the need for postoperative analgesia. We believe that this approach should be considered for patients who require biliary surgery but who are not good candidates for general anesthesia due to cardiorespiratory problems.
authors.affiliation: Department of Surgery, Hospital de Clinicas, University of Cordoba, Cordoba, Argentina.
authors.forename: L
authors.initials: L
authors.lastname: Gramatica
authors.forename: O E
authors.initials: OE
authors.lastname: Brasesco
authors.forename: A
authors.initials: A
authors.lastname: Mercado Luna
authors.forename: V
authors.initials: V
authors.lastname: Martinessi
authors.forename: G
authors.initials: G
authors.lastname: Panebianco
authors.forename: F
authors.initials: F
authors.lastname: Labaque
authors.forename: D
authors.initials: D
authors.lastname: Rosin
authors.forename: R J
authors.initials: RJ
authors.lastname: Rosenthal
authors.forename: L
authors.initials: L
authors.lastname: Gramatica
mesh_terms: D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*