Cholecystectomy in a patient with Broncho pleural fistula - An Anesthesiologist's tight rope walk

Patients presenting for surgery postlobectomy with Broncho pleural fistula are prone for perioperative respiratory complications and pose a significant challenge to anesthetist. Published data to guide perioperative management of such cases especially for abdominal surgeries are scarce. We describe a 51-year-old gentleman status postlobectomy with Broncho pleural fistula posted for cholecystectomy in view of symptomatic gallstones. Laparoscopic surgery was later converted to open surgery in view of surgical difficulties. Perioperative period was uneventful and proper modes of analgesia helped in faster recovery. Proper understanding of physiological and anatomical changes and proper planning of anesthesia facilitated safe and uneventful anesthesia.