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Thoracic gallstones: a delayed complication of laparoscopic cholecystectomy
Jacob F Quail1, Peter W Soballe, Daniel L Gramins
11 Department of General Surgery, Naval Medical Center , San Diego, San Diego, California.
Background:
Thoracic complications resulting from gallstone spillage during laparoscopic cholecystectomy are rare and may occur years after the index surgery. We present the case of a chronic lung abscess resulting from trans-diaphragmatic migration of gallstones spilled and "lost" during a laparoscopic cholecystectomy.
Methods:
Case report and literature review.
Case Report:
A 66-year-old female who had undergone a laparoscopic cholecystectomy 5 y previously presented with hemoptysis and was found to have a chronic lung abscess caused by "lost" gallstones. Her symptoms resolved with video-assisted thorascopic surgery, pulmonary decortication, and wedge resection.
Conclusions:
Thoracic complications from "lost" gallstones following laparoscopic cholecystectomy include empyema, hemoptysis, and cholelithoptysis. These rare complications sometimes require surgery but not all presentations of thoracic gallstones mandate operative intervention. Because of these potential complications of "lost" gallstones, reasonable efforts should be made to retrieve gallstones spilled during cholecystectomy. Persistent pulmonary symptoms following laparoscopic cholecystectomy mandate further radiologic examination and a review of the patient's operative report for "lost" gallstones.
