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Related Experiment Videos

Lost stones during laparoscopic cholecystectomy

J Diez1, C Arozamena, L Gutierrez

  • 1Hospital de Clínicas, Universidad de Buenos Aires.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
|January 20, 1999
PubMed
Summary

Gallbladder perforation during laparoscopic cholecystectomy can lead to spilled stones. Removing these lost gallstones is crucial to prevent complications like abscesses and intestinal obstruction.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation

Background:

  • Gallbladder perforation and stone spillage are known complications of laparoscopic cholecystectomy.
  • Previous studies highlight potential issues in port sites or the abdominal cavity following such events.

Purpose of the Study:

  • To analyze the incidence of gallbladder perforation and retained stones during laparoscopic cholecystectomy.
  • To evaluate the complications associated with retained gallstones and assess management strategies.

Main Methods:

  • Retrospective review of 3686 laparoscopic cholecystectomies performed by 6 surgeons.
  • Analysis of cases with gallbladder perforation and subsequent gallstone spillage into the abdominal cavity.
  • Documentation of stone retrieval, complications, and management outcomes.

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Main Results:

  • Gallbladder perforation occurred in 627 (17%) of 3686 procedures.
  • Gallstones were spilled into the abdominal cavity in 254 patients; 214 stones were retrieved, and 40 were left.
  • Twelve patients developed complications, including abscesses, intestinal obstruction, and port site issues; prompt management was effective.

Conclusions:

  • Retained gallstones after laparoscopic cholecystectomy can cause significant morbidity, necessitating removal, particularly if large or associated with preoperative infection.
  • Routine conversion to open surgery is not indicated for stone spillage, but patient awareness is vital for early complication diagnosis.