An unusual site of gallstones five years after laparoscopic cholecystectomy

Heywood, Sean; Wagstaff, Ben A.; Tait, Noel

doi:10.1016/j.ijscr.2019.02.038

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…This prevents port site contamination and retention of gallstones in the port sites. If any spillage occurs at all at the time of dissection or specimen retrieval, the surgeon should ensure removal of all visible stones and use copious saline irrigation to flush the port site (8). However, in our case we did not find any gallstone in the abscess cavity.…”

Section: Discussionmentioning

confidence: 52%

Unusual Abdominal Wall Abscess Post-Laparoscopic Cholecystectomy

Thimmegowda¹,

Lakshman²

2021

Ann Afr Surg.

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Cholecystectomy is the most commonly performed operation worldwide nowadays. Laparoscopic cholecystectomy (LC) is the gold standard treatment of gallstones. We present a case of an 81-year-old male with a 3-months’ history of loss of appetite and weight with no associated symptoms. The patient had undergone an LC for symptomatic cholelithiasis 1 year previously, with an uneventful recovery. The clinical examination was essentially normal. A computed tomography (CT) of the abdomen and pelvis showed thickening of the right perihepatic peritoneum measuring 15 × 15 × 3.5 cm, suggestive of chronic granulomatous lesion or atypical mesothelioma. We performed a diagnostic laparoscopy and found the lesion to be an abdominal wall abscess. The abscess cavity was deroofed, the pus was drained and a thorough wash out given. Surprisingly no stones or any foreign body were found in the cavity. Histology of the abscess wall showed non-specific inflammation. We report this case as a post-LC abdominal wall abscess with two peculiar features – (a) no systemic or local symptoms, and (b) no association with spilt gallstones or other foreign bodies like sutures.

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Section: Discussionmentioning

confidence: 52%

Unusual Abdominal Wall Abscess Post-Laparoscopic Cholecystectomy

Thimmegowda¹,

Lakshman²

2021

Ann Afr Surg.

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“…The most common site of lost stones was the right subhepatic, perihepatic, retroperitoneal, right flank and pelvis. Ten (12%) out of 85 cases of lost stones discovered incidentally [ 18 , 19 , 23 , 39 , 47 , 49 , 52 , 58 , 71 , 75 ]. Type of lost gallstones discovered during the re-intervention reported by 17 authors(20%), [ 18 – 20 , 24 , 31 , 35 , 39 , 42 , 43 , 53 , 54 , 63 , 80 ]; of those 7 (41%) were pigment and 8 (47%) cholesterol gallstones.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen(20%) of authors reported the number of discovered gallstones [ 18 , 25 , 27 – 29 , 31 , 35 , 38 , 39 , 44 , 45 , 50 , 54 , 57 , 70 , 80 , 83 ]. The size of discovered gallstones was reported by 12(14.11%) authors [ 18 , 19 , 25 , 28 , 31 , 35 , 37 , 52 , 63 ]. The most prevalent presenting symptoms were pain, fever, nausea, vomiting, abdominal swelling, fistula formation, and loss of weight.…”

Section: Resultsmentioning

confidence: 99%

Consequences of the spilled gallstones during laparoscopic cholecystectomy: a systematic review

et al. 2022

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Introduction Complications secondary to spilled gallstones can be classified in the category of disease of medical progress because prior to advent of laparoscopic cholecystectomy very few reports published on the topic. The aim of the present study was to investigate the predisposing factors and the complication rate of spilled gallstones during laparoscopic cholecystectomy over the past 21 years. Methods Embase, Pubmed, Medline, Google scholar and Cochrane library were systematically searched for pertinent literature. Results Seventy five out of 181 articles were selected including 85 patients; of those 38% were men and 62% women. The median age of the cohort was 64 years old and ranged between 33 and 87 years. Only 23(27%) of the authors reported the incident of spillage of the gallstones during the operation. Time of onset of symptoms varied widely from the second postoperative day to 15 years later. Ten of 85 patients were asymptomatic and diagnosed with spilled gallstones incidentally. The rest of the patients presented with complications of severe morbidity and almost, 87% of the patients needed to be treated with surgical intervention and 12% with US ± CT scan guidance drainage. Only one perioperative death reported. Conclusions Symptomatic patients with lost gallstones present with severe morbidity complications and required mostly major surgical procedures. Therefore, standardisation of the management of spilled gallstones is needed urgently. Hospitals need to review their policy with audits and recommendations and clinical guidelines are needed urgently.

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“…Predisposing factors for gallbladder perforation and stone spillage include acute cholecystitis, pericholecystic adhesions, obesity and male sex. The problem of stone spillage is aggravated by spread of calculi because of peritoneal irrigation and pneumoperitoneum [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Acute abdomen due to spilled gallstones: a diagnostic dilemma 10 years after laparoscopic cholecystectomy

Kafadar

Çetinkaya

Aday

et al. 2020

Journal of Surgical Case Reports

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Laparoscopic cholecystectomy (LC) carries a significant risk of gallbladder perforation and resulting scattering of bile stones into the abdominal cavity. The retrieval of the spilled stones is not always possible by laparoscopic technique. Most cases do not create long-term problems, although some cases may be complicated in future and create uncertainties regarding the correct diagnosis. Diagnosis can be difficult, and in most cases the patient may require open surgery for management of these complications. Herein, we report a case of acute abdomen due to spilled stones occurring 10 years after LC. In the first stage, definitive diagnosis could not be made with computed tomography examination. Finally, the patient was diagnosed with explorative laparotomy.

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An unusual site of gallstones five years after laparoscopic cholecystectomy

Cited by 8 publications

References 8 publications

Unusual Abdominal Wall Abscess Post-Laparoscopic Cholecystectomy

Unusual Abdominal Wall Abscess Post-Laparoscopic Cholecystectomy

Consequences of the spilled gallstones during laparoscopic cholecystectomy: a systematic review

Acute abdomen due to spilled gallstones: a diagnostic dilemma 10 years after laparoscopic cholecystectomy

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