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Jaundice due to extrabiliary gallstones
Scott Stevens1, Homero Rivas, Robert N Cacchione
1Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|October 16, 2003
Summary
Dropped gallstones after laparoscopic cholecystectomy can cause serious complications, including bile duct compression and jaundice, even a year later. Surgeons must retrieve spilled stones to prevent delayed adverse events.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Hepatobiliary Surgery
Background:
- Laparoscopic cholecystectomy is a common procedure with patient benefits.
- Potential complications include bile duct injury and dropped gallstones.
- Dropped gallstones can lead to delayed complications.
Observation:
- A patient presented with jaundice and pruritus 12 months post-laparoscopic cholecystectomy.
- Imaging revealed cholelithiasis despite prior surgery.
- Endoscopic retrograde cholangiopancreatography showed common hepatic duct stenosis.
Findings:
- Exploratory laparotomy revealed an abscess with gallstones compressing the common hepatic duct.
- Gallstone extraction and hepaticojejunostomy led to slow bilirubin level decrease.
- The patient recovered without further complications.
Implications:
- Lost gallstones can cause significant extraluminal compression and biliary obstruction.
- Delayed complications from dropped gallstones are possible.
- Meticulous retrieval of spilled gallstones during surgery is crucial to prevent long-term adverse events.