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"The stones...to rise".
D Bandyopadhyay1, C R Kapadia, S G Blake
1Department of Surgery, Airedale General Hospital, West Yorkshire, UK. DibyenduAditi@aol.com
Surgical Endoscopy
|July 5, 2002
Summary
Gallstone spillage during laparoscopic cholecystectomy can lead to late, recurrent subphrenic abscesses years after surgery. This case highlights the importance of preventing stone spillage and considering open drainage for such complications.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Imaging
Background:
- Laparoscopic cholecystectomy is a common procedure.
- Late complications, particularly those arising from gallstone spillage, are infrequently documented.
- Subphrenic abscesses are a known, albeit uncommon, complication.
Observation:
- A 65-year-old male presented with recurrent subphrenic abscesses 3 and 10 years post-laparoscopic cholecystectomy.
- Computed tomography (CT) scans revealed significant findings related to the abscesses.
- The patient had a history of gallstone spillage during the initial laparoscopic procedure.
Findings:
- Gallstone spillage during laparoscopic cholecystectomy can result in delayed and recurrent subphrenic abscess formation.
- CT imaging is crucial for diagnosing and characterizing these late-onset complications.
- Open surgical drainage demonstrated efficacy in managing the recurrent abscesses.
Implications:
- This case underscores the potential for long-term sequelae from gallstone spillage during laparoscopic cholecystectomy.
- Preventative measures to minimize stone spillage are critical for patient safety.
- Open surgical drainage may be preferred over percutaneous methods for complex, recurrent subphrenic abscesses post-cholecystectomy.