Retroperitoneal abscess as a late complication following laparoscopic cholecystectomy

Gallstone spillage during laparoscopic cholecystectomy is a relatively common occurrence. These intraperitoneal gallstones are considered to be harmless. Rarely, they may give rise to complications. Surgeons should retrieve spilled stones whenever possible.

We report the case of a 75-year-old man with retroperitoneal abscess that developed 6 years following laparoscopic cholecystectomy as a late complication. The cavity, though it drained purulent material, was sterile in culture. Gallstones were found in the drain effluent. To our knowledge this is the first case report in English of such a delayed complication caused by spilled gallstones.

Every effort should be made to avoid perforation of the gall bladder during its dissection. Whether the procedure should be converted to open surgery to retrieve all the stones is subject to debate.