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Laparoscopic cholecystectomy in a patient with erythropoietic protoporphyria.
[erythropoietic protoporphyria]
Erythropoietic
protoporphyria
(
EPP
)
is
an
inherited
defect
in
haem
synthesis
causing
dangerous
phototoxic
reactions
following
exposure
to
wavelengths
of
light
around
400
nm
.
It
can
cause
catastrophic
post-operative
complications
following
open
surgery
,
in
which
environment
various
safety
measures
are
now
routinely
employed
.
The
dangers
at
laparoscopy
have
never
been
discussed
in
the
literature
,
and
nor
have
any
specific
precautions
been
recommended
.
We
describe
a
35
year
old
woman
with
gallstones
undergoing
prophylactic
laparoscopic
cholecystectomy
to
prevent
future
cholestasis
precipitating
porphyric
liver
failure
.
A
pre-operative
trial
of
the
cutaneous
effects
of
the
laparoscopic
light
source
was
performed
to
assess
the
potential
risk
of
use
within
the
peritoneal
cavity
.
The
procedure
was
uneventful
and
the
patient
suffered
no
adverse
reaction
.
We
suggest
that
a
trial
of
the
effects
of
the
laparoscopic
light
source
on
the
skin
of
EPP
patients
provides
valid
reassurance
regarding
the
safety
of
the
laparoscopy
for
short
surgical
procedures
.
