Laparoscopic cholecystectomy under spinal anesthesia in a patient with limb-girdle muscular dystrophy

摘要

A 61-yr-old gentleman with longstanding muscular dystrophy presented with acute cholecystitis and sepsis. Three months later, with a biliary drainage tube still in place, he presented for semi-elective laparoscopic cholecystectomy. This patient kindly gave consent for publication of this report. The exact type of the patient's muscular dystrophy was unclear despite extensive workup by his neurologist; however, his presentation was most in keeping with limb-girdle muscular dystrophy Type 2A.1 His symptoms began at age 14 yr when he developed proximal upper arm weakness and subsequent muscle wasting. By age 50 yr, he began to develop progressive weakness and wasting of his proximal lower limbs. He is now unable to climb out of bed or climb stairs easily. His echocardiogram was unremarkable and, surprisingly, so was the result of his preoperative spirometry test. Nevertheless, his respiratory therapist noted he was quite dyspneic at the end of the spirometry testing.