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Gallstone empyema complicating laparoscopic cholecystectomy.
R DeVincenzo1, L B Haramati, E L Wolf
1Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA.
Journal of Thoracic Imaging
|June 29, 2001
Summary
Delayed empyema can occur after laparoscopic cholecystectomy due to dropped gallstones. These gallstones may migrate through the diaphragm, especially in elderly patients with pre-existing defects, leading to this rare complication.
Area of Science:
- Gastroenterology
- Surgical Complications
- Thoracic Surgery
Background:
- Laparoscopic cholecystectomy is a common surgical procedure.
- Empyema is a rare but serious complication following abdominal surgery.
- Dropped gallstones are a known risk in laparoscopic cholecystectomy.
Observation:
- This study investigates a rare presentation of empyema as a delayed complication.
- The complication is consistently associated with dropped gallstones within the peritoneal cavity.
- Gallstone migration through the diaphragm or pre-existing diaphragmatic defects is observed.
Findings:
- Dropped gallstones can lead to delayed empyema after laparoscopic cholecystectomy.
- Gallstones may erode through the diaphragm or migrate via existing defects.
- Over 50% of elderly individuals have diaphragmatic defects, increasing risk.
Implications:
- Highlights a rare but significant delayed complication of laparoscopic cholecystectomy.
- Emphasizes the importance of careful surgical technique to minimize gallstone spillage.
- Suggests considering diaphragmatic integrity in elderly patients with dropped gallstones and respiratory symptoms.