An assessment of potential complications caused by intraperitoneal gallstones

Perforation of the gallbladder with spillage of stones into the peritoneal cavity occurs frequently during laparoscopic cholecystectomy. In order to study the effects of these stones, the authors placed no gallstones (Group I, n = 6), one stone (Group II, n = 12), or five stones (Group III, n = 12) within the peritoneal cavity of Sprague-Dawley rats. One-third of the animals in each group were then killed at intervals of 2, 4, and 8 weeks. At necropsy, the location of each stone was noted as well as any evidence of adhesion, fistula, perforation, or obstruction. No difference between groups with respect to presence of adhesions, density of adhesions, or stone location was noted, though there was a trend toward more stones becoming fixed within the abdomen over time. Perforation of the gallbladder with spillage of sterile stones does not appear to cause increased morbidity during or after laparoscopic cholecystectomy.