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Cholelithoptysis. A complication following laparoscopic cholecystectomy
G H Downie1, M K Robbins, J J Souza
1University of North Carolina Hospitals, Department of Medicine, Chapel Hill.
Chest
|February 1, 1993
Summary
A rare case of gallstone expectoration (cholelithoptysis) occurred in a woman post-laparoscopic cholecystectomy. This unusual complication highlights potential gallstone retention issues after gallbladder surgery.
Area of Science:
- Gastroenterology
- Surgical Complications
- Pulmonary Medicine
Background:
- Laparoscopic cholecystectomy is a common procedure for symptomatic cholecystitis.
- Gallstone disease can lead to various complications if not fully treated.
Observation:
- A 59-year-old woman presented with hemoptysis and lithoptysis four months after laparoscopic cholecystectomy.
- Expectorated material was chemically analyzed and confirmed to be gallstones.
- Imaging revealed supradiaphragmatic and subdiaphragmatic fluid collections with echogenic fragments.
Findings:
- The patient experienced cholelithoptysis, the expectoration of gallstones.
- Endoscopic retrograde cholangiopancreatography (ERCP) did not reveal retained ductal stones or fistula.
- This represents the first reported case of cholelithoptysis following laparoscopic cholecystectomy.
Implications:
- This case suggests gallstone retention can lead to unusual migratory complications.
- It underscores the importance of thorough intraoperative assessment for retained stones.
- Further investigation into the mechanisms of gallstone migration and expectoration is warranted.