Expert: Ronald Levy, M.D. - 6/4/2011

Question
Hello,
My father had an Ischemic right Middle cerebral artery stroke in last August due to 2 month Aspirin off and after that he has been doing well ever since but last week he had a post stroke seizure and the reason of this seizure was the reduced amount of Valproic acid in blood. he is taking Aspirin plus clopidogrel drug, anticonvulsant drugs (Epival 250mg , Topiramate )and Ropinirole etc. he has gallstone of about 9 cm and doctor advised him to go Laparoscopy but The neurophysician says it's too risky. Is his risk of stroke or other complications under general anesthesia significantly greater? gallstone is creating many complication for pancreas and liver.My father had pancreatitis in last year and still he has a little elevated serum Lipase and amylase and also have low SGPT enzyme and high gamma GT .... please guide me what should i do ???

Answer
While your father is always at a higher risk than the average person, the benefits of the surgery outweigh the risks. If the gallstone is that large, there is no other way to remove it other than surgery and laparoscopic is probably the least invasive and safest way to do it. I would suggest doing it in a teaching hospital (if it is available) because they are better prepared for these kinds of patients.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston