Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy

Morris, Michael W.; Barker, Andrea K.; Harrison, J. Michael; Anderson, Andrew J.; Vanderlan, Wesley B.

doi:10.4293/108680813x13654754534314

Cited by 7 publications

(3 citation statements)

References 27 publications

(29 reference statements)

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“…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. 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 ].…”

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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Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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“…In the literature, complications from unretrieved gallstones have been described as occurring years or even decades later [ 15 - 17 ]. Morris et al reported a 71 year-old-female who presented with complete bowel obstruction 15 years after LC [ 18 ]. Exploratory laparotomy revealed cholesterol gallstones throughout the abdomen and many calculi were found embedded within a dense mesenteric cicatrix causing ileocolic volvulus.…”

Section: Discussionmentioning

confidence: 99%

Practices and Attitudes of Surgeons With Regard to Spilled Gallstones During Laparoscopic Cholecystectomy: A Cross-Sectional Study From Saudi Arabia

Alfehaid,

Aljohani,

Salati

et al. 2024

Cureus

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Background: Gallbladder perforation and gallstone leakage are frequent complications following laparoscopic cholecystectomy (LC). Failure to remove gallstones may result in several issues that manifest immediately or years later. The goal of this study was to evaluate the attitudes of surgeons and the procedures used by them to deal with gallstone spillage during LC. Methods: A cross-sectional design was followed. Surgeons in nine healthcare facilities in the Qassim region of Saudi Arabia were approached through non-probability convivence sampling and the survey was distributed in each of the general surgery divisions. The study included general surgeons who currently performed LC and incomplete responses and interns were excluded. A self-administered questionnaire was developed with 18 questions regarding demographics, center, and designation at the hospital, surgeons’ experience of LC, and exposure to gallstone spillage. Furthermore, items regarding knowledge, attitude, and self-reported practices related to gallstone spillage such as incidence, complications, and intervention taken to prevent gallstone spillage were also included. The level of significance was set at P <0.05. Results: There were 82 participants of both genders, including consultants, specialists, and residents. While only 23 (28%) participants had actually observed patients with complications from spilled stones, 46 (56.1%) participants were aware of this possibility, 53 (64.6%) deemed it inappropriate to bring up gallstone spillage when securing consent for LC, and 67 (81.7%) believed that such an incident needed to be documented in the operation notes. Only 11 (13.4%) thought that the complications arising out of the unretrieved gallstones should fall under the legal purview of the operative surgeon. There were very few complications of spilled gallstones that the participants were aware of, and none of them anticipated problems to arise more than three years after LC. Conclusions: Awareness of the risks associated with gallstone spillage during LC needs to be raised, and it is imperative to standardize the practices related to their management.

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“…The operating urologist was trained in both transperitoneal and retroperitoneal approaches; but in view of likely adhesions from the patient’s previous transabdominal surgeries, a retroperitoneal approach was opted for. With respect to laparoscopic surgery, caecal volvulus has been reported following laparoscopic: cholecystectomy, nephrectomy and appendectomy 20 22–24…”

Section: Discussionmentioning

confidence: 99%

Caecal volvulus following left-side laparoscopic retroperitoneal nephroureterectomy

et al. 2019

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Caecal volvulus is an uncommon cause of intestinal obstruction, with a high associated morbidity and mortality. Caecal volvulus is a very rare complication following retroperitoneal surgery. As such, a high degree of clinical suspicion is warranted post operatively to minimise delay in definitively investigating and managing this condition. We present a case of an 80-year-old Caucasian woman who was admitted for an elective left-sided laparoscopic retroperitoneal nephroureterectomy for transitional cell carcinoma of the left upper pole renal calyx. Postoperatively, the patient developed intestinal obstruction, secondary to caecal volvulus. The patient underwent an emergency laparotomy and limited right-sided colonic resection with primary anastomosis.

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Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy

Abstract: Complications can arise from spilled gallstones during cholecystectomy. A surgeon should make every effort to avoid gallbladder perforation and spillage of stones during laparoscopic cholecystectomy.

Cited by 7 publications

References 27 publications

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

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

Practices and Attitudes of Surgeons With Regard to Spilled Gallstones During Laparoscopic Cholecystectomy: A Cross-Sectional Study From Saudi Arabia

Caecal volvulus following left-side laparoscopic retroperitoneal nephroureterectomy

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