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Related Experiment Videos

The lost gallstone. Complication after laparoscopic cholecystectomy

R N Gallinaro1, F B Miller

  • 1Department of Surgery, University of Louisville School of Medicine, KY 40292.

Surgical Endoscopy
|August 1, 1994
PubMed
Summary

Gallstones spilled during laparoscopic cholecystectomy can cause complications. This case report details an abscess formation requiring surgical intervention for resolution, highlighting the importance of complete stone removal.

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Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Abdominal Surgery

Background:

  • Laparoscopic cholecystectomy is the standard surgical treatment for symptomatic gallstones.
  • Accidental gallbladder perforation during surgery can lead to free spillage of gallstones into the peritoneal cavity.
  • Complete retrieval of spilled gallstones can be challenging, and their long-term fate is not well-documented.

Observation:

  • A patient developed a deep-seated abscess in the right flank eight months after laparoscopic cholecystectomy.
  • The abscess was associated with retained gallstones within the peritoneal cavity.
  • Purulent exudate required drainage, and the sinus tract failed to heal until the gallstones were surgically removed.

Findings:

  • Retained gallstones in the peritoneal cavity after laparoscopic cholecystectomy can lead to delayed infectious complications such as abscess formation.

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  • Complete surgical removal of spilled gallstones is crucial for resolving such complications and promoting healing.
  • This case underscores a potential, albeit uncommon, adverse outcome of iatrogenic gallstone spillage.

    • Implications:

    • Surgeons should prioritize meticulous identification and removal of all spilled gallstones during laparoscopic cholecystectomy.
    • Awareness of this complication is important for timely diagnosis and management of post-cholecystectomy patients presenting with unusual abdominal pain or masses.
    • Further studies may be warranted to elucidate the precise incidence and natural history of asymptomatic retained gallstones.