Traditional operative management for chylous drainage refractory to conservative therapy is thoracic duct ligation via right open thoracotomy. This case report details successful thoracoscopic ligation of the thoracic duct for a chylous leak following a left neck dissection. Since the thoracoscopic approach is less morbid than open thoracotomy, early operative management is recommended for thoracic duct injuries.

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The recent development of laparoscopic cholecystectomy has introduced the technique of laparoscopy to the general surgical community. As increasing numbers of laparoscopic cholecystectomies are performed, increasing numbers of complications directly related to laparoscopy will result. A case of subcutaneous emphysema and hypercarbia without pneumothorax is reported in a patient undergoing laparoscopic cholecystectomy. Etiology, evaluation, and therapy for subcutaneous emphysema associated with laparoscopy are reviewed.

Laparoscopic cholecystectomy has become the preferred method for removal of the diseased gallbladder. While its morbidity and mortality rates are lower than those of the open technique, it does have associated complications which may cause significant morbidity. The morbidity associated with spilled gallstones is not well studied and little can be found in the literature on this subject. We encountered a patient who developed abscesses within the abdominal wall following laparoscopic cholecystectomy. We recommend that spilled gallstones be removed when possible and that surgeons be aware of this possible complication.