Gallstone umbilical sinus tract formation following laparoscopic cholecystectomy

The use of laparoscopic techniques in general surgical procedures has increased dramatically in the past 6 years. A number of articles in the literature have described a multitude of complications arising from these techniques. We report the development of a draining umbilical sinus tract following laparoscopic cholecystectomy, arising as a result of gallstone fragmentation during gallbladder removal. Despite aggressive local treatment, there was no improvement in the condition of the umbilical trocar site, necessitating wide excision of the umbilicus and trocar site. Although subcutaneous abscesses from gallstone fragments have been reported in the literature, to our knowledge this is the first report in which the subsequent development of a sinus tract required a second operative procedure for resolution. In addition, we suggest several methods for the prevention of abscess or sinus tract formation following laparoscopic cholecystectomy.