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Sepsis from dropped clips at laparoscopic cholecystectomy
1Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. sarwathussain@hotmail.com
European Journal of Radiology
|December 4, 2001
Summary
Dropped surgical clips and gallstones in the abdomen after laparoscopic cholecystectomy can cause complications like abscesses. While often asymptomatic, these retained foreign bodies represent an additional risk for post-operative sepsis.
Area of Science:
- Surgical complications
- Gastrointestinal surgery
- Medical imaging
Background:
- Laparoscopic cholecystectomy (LC) is a common surgical procedure.
- Retained foreign bodies, such as surgical clips and gallstones, can occur during LC.
- Abdominal abscesses are a known complication, particularly from dropped gallstones.
Purpose of the Study:
- To report cases of retained surgical clips and gallstones in the peritoneal cavity after LC.
- To assess the complications associated with these retained foreign bodies.
- To highlight the risk of dropped clips as a cause of post-LC sepsis.
Main Methods:
- Retrospective review of radiological studies in seven patients.
- Identification of dropped surgical clips and gallstones in the peritoneal cavity.
- Correlation with clinical outcomes, including abscess formation and surgical intervention.
Main Results:
- Seven patients had dropped clips (5) or gallstones (2) visualized radiologically.
- Two patients developed subphrenic abscesses and empyemas due to dropped clips.
- One clip abscess was surgically treated; other cases were incidental findings without complications.
Conclusions:
- Dropped surgical clips, though usually asymptomatic, are an additional risk factor for post-LC abdominal sepsis.
- Retained gallstones can also lead to abdominal abscesses, a recognized complication.
- Radiological surveillance is important for identifying retained foreign bodies after laparoscopic cholecystectomy.