Name

Dr. G. Gopalakrishnan

Institute / Department

Surgical Gastroenterology

Qualification

M.S., M.Ch (JIPMER).,

Designation

Consltant -.Gastro,HBP Surgeon

Years in Practice

8+

Surgeries (Nos)

1200+

Procedures (Nos)

500+

Memberships

Indian Medical Association

Expertise

Laparaoscopic Whipples Procedure. Thoraclaproscopic Esophagectomy Laparoscopic Colorectal Resections Laparoscopic Pancreatectomy Major Liver Resections Endoscopic Stenting Trans Arterial Chemo Embolization TACE for Liver Tumors. Portal hypertension Surgery & Bariatric Surgery,


Medical Happenings

Spinal Stabilization for Paraplegia in Chronic Liver Disease / Hepatic Failure Patient

44 year old male in liver failure with L1 vertebral body fracture following a trivial fall. He was paraplegia post fall and referred to us for surgical stabilisation of the spine. Patient had a platelet of 30,000 and Hb of 8 due to Chronic Liver Disease and related portal hypertension, splenomegaly. After explaining in detail regarding the complications and post op liver failure he was taken up for surgery. Since it was a transition segment 4 level pedicle screws was planned.
Case was discussed with Anesthesia team  and Gastroenterologist. Since there was splenomegaly and patient already in liver dysfunction any platelet transfusion will not improve his levels. So, he was planned for surgery with 2 single donor platelet and 4 fresh frozen plasma on flow. The procedure was completed in 1.30 hrs and patient extubated by 2 hrs and shifted to ward after observing for any liver failure signs. He went in for liver failure on second post op day and platelets dropped to 10k and bilirubin to 15 and Hb to 6. All these were previously anticipated and managed very well by Dr. Gopalakrishnan. He was mobilised and weight bearing exercises started on 5th Post Operative Delirium.. Now the patient is walking on his own.  We wanted to highlight the outcome of this patient which was possible only due to the team effort.


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