Low-Flow Anesthesia Management in Pediatric Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Report
DOI:
https://doi.org/10.24843/xqsck350Keywords:
Choledochal cyst, Laparoscopic surgery, Low-flow anesthesia, Pediatric anesthesia, SevofluraneAbstract
Laparoscopic surgery offers significant benefits in pediatric populations but presents anesthetic challenges, especially during prolonged procedures. This case report describes the anesthetic management of an 11-year-old boy who underwent nearly 12 hours of laparoscopic choledochal cyst excision, Roux-en-Y hepaticojejunostomy, and cholecystectomy. Low-flow anesthesia using sevoflurane was administered via a Dräger Perseus A500, enabling precise control of anesthetic delivery, oxygenation, and ventilation. Throughout the procedure, inspired oxygen fraction (FiO₂) was maintained above 30%, and end-tidal CO₂ (EtCO₂) remained stable around 35 mmHg. Volatile agent consumption was reduced, with age-adjusted MAC (xMAC) consistently between 0.85 and 0.90. Intraoperative hemodynamics and postoperative recovery were stable, with no immediate complications. This case highlights the safety, efficiency, and cost-effectiveness of low-flow anesthesia in complex pediatric laparoscopic surgery when guided by advanced monitoring systems and supports its broader adoption in resource-limited healthcare settings.
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Data Availability Statement
De-identified patient data from this case report will be made available upon reasonable request to the corresponding author following publication, subject to institutional data-sharing policies and ethics approval.
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Copyright (c) 2025 Togi Stanislaus Patrick, I Gusti Ngurah Mahaalit Aribawa, Marilaeta Cindryani Ra Ratumasa, A A Gde Adistaya (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share, use, distribute, and reproduce the work in any medium, provided the original author and source are properly credited.
