Fail to Retrieve Gallstones in Laparoscopic Cholecystectomy- A Study

Abstract

BACKGROUNDGallstone spillage during laparoscopic cholecystectomy is not uncommon and despite all precautions and adoption of safety measures spilt gallstone remain unretrieved. We are trying to document the incidence of spilt gallstones during laparoscopic cholecystectomy, the cause and consequences of such spillage, probable measure to be adopted to prevent gallstone spillage during laparoscopic cholecystectomy and to take care to retrieve all spilt stones. MATERIALS AND METHODSThe study included 150 consecutive laparoscopic cholecystectomy pardoned between October 2014 and November 2015. Data were collected in a prospective manner. Detail study was conducted in terms of diagnosis and consequences of spillage of gallstones. Followup were performed at the end of 1 week, 1 month, 6 months and 1 year. RESULTSThe spillage of gall stones during surgery occurred in 19.04% of the cases. Majority of the spillage occurred due to perforation of the gall bladder during dissection followed by application of toothed grasper. Although, all visible spilt stones were retrieved during surgery, complication rate of 0.66% was observed. CONCLUSIONThe incidence and complications secondary to the spillage of gall stones during standard laparoscopic cholecystectomy is low, but avoidable; various complications can occur over a large period of time. Thus, it is advisable to retrieve as many gallstones as possible, short of converting to a laparotomy.

Incidence, Risk Factors and Outcome of Gallbladder Perforation during Laparoscopic Cholecystectomy

“…Male gender, with a prior history of previous laparotomies, an inflamed gallbladder and a difficult operation have all been associated to an increased risk of GP [6][7][8]. Benign gallbladder disease is treated by laparoscopic cholecystectomy rather than open surgery [9].…”