Gallstone spillage is a common intraoperative event during laparoscopic cholecystectomy (LC). Patients present months to years with nonspecific symptoms after the original procedure. The complications of retained peritoneal gallstones are infrequent. Having a high index of suspicion is the key to early diagnosis. Every effort should be made to remove spilled gallstones at the index operation to prevent future complications, however, conversion from laparoscopy to laparotomy for retrieval of spilt gallstone is not recommended. Here we present a case of retained gallstone presenting as a large intra-abdominal mass four years after laparoscopic cholecystectomy in a middle age bariatric patient.
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