腹腔鏡下胆嚢摘出術後の胆石遺残によるまれな晩期壁合併症：症例報告

Retained gallstones after laparoscopic cholecystectomy (LC) are uncommon but can cause late abscesses or fistulas, sometimes years after surgery. Their recognition remains essential to avoid misdiagnosis. A 70-year-old man presented four years after LC with a right hypochondrial swelling. Imaging revealed a parietal abscess containing multiple gallstones. Percutaneous drainage followed by surgical extraction was performed. Morganella morganii was cultured, and the patient recovered uneventfully. Gallstone spillage during LC is frequent but rarely leads to clinical complications. Retained stones may act as foreign bodies and become infected, leading to chronic abscess formation. Imaging, particularly computed tomography, is crucial for diagnosis, and complete surgical removal is the cornerstone of treatment. Retained gallstones should be suspected in patients with unexplained parietal or intra-abdominal abscesses years after surgery. Prevention through meticulous technique and documentation is critical.