Mismanagement of Elective Cholecystectomy Causes Severe Electrolyte Imbalance

Case Overview

This case involves a 46-year-old female patient who presented to the hospital for elective cholecystectomy. The patient was admitted to the hospital for almost a week to rule out the possibility of gall bladder carcinoma and was kept NPO for 7 days. Lab work showed that she was dehydrated and had severe electrolyte imbalances at which point the house staff aggressively gave fluid resuscitation. The surgery was less than 24 hours away when the lab work showed the dehydration and electrolyte disturbances but the surgery was continued anyway. The physicians experienced great difficulty intubating the patient.

Questions to the General Surgery expert and their responses

Was this patient's surgery necessary given her status right before surgery and the fact that it was elective in nature, could it have been delayed until she was more stable?

I believe this case warrants further review in light of the fact that the initial workup of the patient involved suspected cancer, therefore I think the physicians giving care to this patient should have looked into a few other venues before sending this woman into surgery.

About the expert

This expert is a board certified General surgeon with additional fellowship training in minimally invasive surgical techniques. He was trained at the University of California Davis School of Medicine for residency and at Johns Hopkins for fellowship. He is the Director of a surgical hernia center at a prestigious medical university in Maryland and treats a significant amount of cancer patients.