title: Haemodynamics in a patient with Fontan physiology undergoing laparoscopic cholecystectomy.
abstract: Laparoscopic surgery in patients with Fontan circulation is a haemodynamic challenge; venous return may be compromised by insufflation of carbon dioxide into the abdomen (increasing intra-abdominal pressure), the use of reverse Trendelenburg position and positive pressure ventilation. Combined with an increase in pulmonary vascular resistance due to hypercarbia, cardiac output may be reduced. However, for non-haemodynamic reasons, laparoscopic surgery has advantages over open surgery: less postoperative pain, shorter hospital stay, a reduction in postoperative wound infections and a reduction of respiratory complications. In this case report, we present a patient with Fontan circulation who underwent uneventful laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands, s.j.a.pans@umcutrecht.nl.
authors.forename: S J A
authors.initials: SJ
authors.lastname: Pans
authors.forename: R R J
authors.initials: RR
authors.lastname: van Kimmenade
authors.forename: J P
authors.initials: JP
authors.lastname: Ruurda
authors.forename: F J
authors.initials: FJ
authors.lastname: Meijboom
authors.forename: G T
authors.initials: GT
authors.lastname: Sieswerda
authors.forename: B
authors.initials: B
authors.lastname: van Zaane