I agree, he had mental health issues even before the surgery.
I said it before and I'll say it again, I would never ever undergo that surgery, not even if they promised me with 100% certainty that I will live another year or two, which is not even the case, nothing is promised. I wouldn't fancy spending months in agony, I actually don't believe that the recovery time is 3 months like they say, that sounds like a best case scenario time frame but so many things can go wrong that I'm sure it's typically longer than that. What's the point? And what quality of life do patients have after the surgery? I've read that it's considered a controversial surgery and I can see why.
Now if Paul survives this I'm afraid he's gonna be very depressed during the long and painful recovery time. I mean, this is a guy who was panicking in tears in the video right before the surgery, when he had some shortness of breath probably due to anxiety + the ascitis that needed draining.