[Complications due to a lost gallstone; a differential to consider even years after laparoscopic cholecystectomy]

Laparoscopic cholecystectomy is a commonly performed surgery. Lost gallstones intraoperatively can cause short- and long-term complications. We present a case of a 70-year-old male who presented 15 years after a laparoscopic cholecystectomy. He presented with abdominal sepsis secondary to a perforated large abscess formed around an intraabdominal gallstone. He underwent an acute laparoscopy where 300ml of pus was drained and was admitted to the intensive care unit postoperatively. He was later readmitted with a new abscess with colonic involvement. A percutaneous drainage was performed and later a partial sigmoidectomy was needed. He had a delay of the right diagnosis due to the late presentation postoperatively. Efforts should be made to retrieve spilled gallstones during a laparoscopic cholecystectomy. If this is not possible, it should be documented adequately in surgical notes and discharge letters. Gallstones from a prior cholecystectomy should be kept in the differential diagnosis even years postoperatively.