Long-Term Complications of Retained Gallstones After Minimally Invasive Cholecystectomy: Hidden Perils

Minimally invasive cholecystectomy (MIC) is the preferred procedure for the treatment of acute cholecystitis. A common intraoperative complication includes gallbladder perforation with gallstone spillage into the peritoneal cavity. Though retained patients with gallstones are generally asymptomatic, they can, on rare occasions, present with complications months to years later. A wide range of complications, ranging from abscess formation to more unusual sequelae such as lumbar hernias, is possible. We present two atypical cases of retained gallstones following MIC to highlight the need for recognition of this complication. The first case is of a 43-year-old male who presented with persistent right upper quadrant pain six months post-laparoscopic cholecystectomy. A computed tomography (CT) scan revealed three gallstones as the nidus of infection. The second case is of a 78-year-old female who presented with recurrent intra-abdominal abscesses, eventually requiring a right-sided lumbar hernia repair, resulting from her retained gallstones.