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Lost gallstones: a relaparoscopic solution to laparoscopic pollution.
M Van Hoecke1, P Lissens, M Vuylsteke
1Department of Surgery, Sint-Andries ZH Tielt, University Hospital Gent, Belgium.
Acta Chirurgica Belgica
|April 1, 2004
Summary
A rare complication of gallstones lost after gallbladder removal surgery caused a gluteolumbar fistula. This case report details successful treatment using radiological intervention and therapeutic relaparoscopy.
Area of Science:
- Gastroenterology
- Surgical Complications
- Interventional Radiology
Background:
- Laparoscopic cholecystectomy is a common procedure for gallstone disease.
- Lost gallstones can lead to rare but serious intra-abdominal complications.
- Gluteolumbar fistula is an uncommon sequela of retained gallstones.
Observation:
- A patient presented with a gluteolumbar fistula 5 years post-laparoscopic cholecystectomy.
- The fistula was attributed to retained, migrated gallstones.
- Diagnostic imaging confirmed the presence and extent of the fistula.
Findings:
- A combined treatment approach involving interventional radiology and therapeutic relaparoscopy was employed.
- Radiological intervention facilitated targeted management of the fistula.
- Therapeutic relaparoscopy allowed for definitive surgical management and removal of the causative gallstones.
Implications:
- This case highlights the potential for delayed complications from retained gallstones.
- Combined radiological and surgical approaches can effectively manage complex fistulas.
- Adherence to surgical best practices may reduce the incidence of retained gallstones.