Free intra-peritoneal gall-stones following laparoscopic cholecystectomy

Walshaw, C.F.; Deans, Heather; Krukowski, Z. H.

doi:10.1016/s0009-9260(05)81013-x

Cited by 16 publications

(7 citation statements)

References 5 publications

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“…They have been described as subhepatic [3], subphrenic [12,39], and intraabdominal abscesses [9,18,19,33,49,54,60,66], but also as a subhepatic inflammatory mass of slow evolution [62], as a intraabdominal mass developing intestinal occlusion [14] or bowel perforation [35], as pelvis abscess [49], as migration into the ovary [2,61], and as implantation in the Douglas pouch [61,63] with the development of lower abdominal pain and dyspareunia. It has also been reported as a parietal mass [64] or as migration through the retroperitoneum to a previous surgical wound [37] or migration to the chest and location in the pleura [7] or expulsion through the bronchia [12,37]. More usually, a cutaneous abscess situated or not near a trocar hole is debrided, and results in chronic sinus and fistula formation until all the stone debris is evacuated [8, 9, 19, 21-23, 27, 29, 40, 51].…”

Section: Clinical Influencementioning

confidence: 95%

“…Stones in the abdominal cavity may induce confusion if they are observed by X-ray examination for abdominal pain [4,64].…”

Section: Clinical Influencementioning

confidence: 99%

“…Lingam [40] 1993 Eisenstat [22] 1993 Tsechmelitsch [60] 1993 Walshaw [64] 1993 Guy [29] 1993 Van Brunt [62] 1994 Golub [27] 1994 Gallinaro [26] 1994 Kraft [35] 1994 Leslie [39] 1994…”

Section: Clinical and Experimental Studiesmentioning

confidence: 99%

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The spilled stone

et al. 1995

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The application of laparoscopic techniques in digestive surgery to areas in which there was no previous experience has favored the appearance of new complications and clinical situations that were not observed during the open era. Initial opinion considered that stones left in the abdominal cavity were harmless, and a few clinical and experimental studies supported this opinion. But cumulative reports of cases suggest a potential danger. From 1991 to date, 49 cases of complications related to stones left in the abdominal cavity have been reported with severe complications that required an open surgical procedure. Stone spillage has not always been considered an indication of conversion of laparoscopic cholecystectomy but is now accepted as a source of infrequent but severe complications that may require a reintervention for treatment. Therefore it is recommended that efforts should be made to retrieve all spilled stones; the surgical procedure should be prolonged until this is achieved, in order to reduce one source of unpredictable morbidity. Open retrieval should be considered in selected cases if a large number or large stones are lost.

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Section: Clinical Influencementioning

confidence: 95%

“…Stones in the abdominal cavity may induce confusion if they are observed by X-ray examination for abdominal pain [4,64].…”

Section: Clinical Influencementioning

confidence: 99%

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The spilled stone

et al. 1995

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“…However, a number of reports demonstrate that, on occasion, these unretrieved gallstones may cause localized or systemic infection [45,66], inflammation [3,65], fibrosis [22], adhesions [62], cutaneous sinuses [7], fistula [8], small bowel obstruction [13,26], generalized septicemia [45], empyema [33], and intra-and extraabdominal abscesses [3,14].…”

mentioning

confidence: 99%

The outcome of unretrieved gallstones in the peritoneal cavity during laparoscopic cholecystectomy

et al. 1999

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“…8 It is unclear as to the exact short-and long-term sequelae of these intraoperative complications. However, retained intraperitoneal stones may act as a nidus for infection, 9 and bile spillage can cause chemical peritonitis, leading to systemic and local infection, 10,11 intraperitoneal abscesses, 12 fistulae, 13,14 adhesions, 15 and smallbowel obstruction. 16 One method suggested to reduce gallbladder perforation and subsequent complications is aspiration (ASP) of the gallbladder.…”

Section: O Riginally Described In 1985mentioning

confidence: 99%

A Meta-analysis of Outcomes After Routine Aspiration of the Gallbladder During Cholecystectomy

Siddiqui

Sajid

Nisar

et al. 2011

International Surgery

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We conducted a meta-analysis of published literature comparing outcomes after aspirating (ASP) the gallbladder versus nonaspiration (NASP). Electronic databases were searched from January 1985 to November 2009. A meta-analysis was performed to obtain a summative outcome. Two randomized, controlled trials involving 360 patients were analyzed. A total of 180 patients were in the ASP group, and 180 were in the NASP group. There was no significant increase in operative time in the ASP group compared with the NASP group [random-effects model: standardized mean difference, 20.72; 95% confidence interval (CI), 22.16, 0.71; z = 0.99; df = 1; P = 0.32], but there was significant heterogeneity among trials (Q = 42.4; P , 0.001; I 2 = 98%). Patients undergoing ASP were less likely to have a gallbladder perforation [random-effects model: risk ratio (RR), 0.42; 95% CI, 0.19, 0.96; z = 2.05; df = 1; P , 0.05], but no difference was found regarding the loss of gallstones (random-effects model: RR, 1.33; 95% CI, 0.30, 5.85; z = 0.38; df = 1; P = 0.70). No difference was seen for liver bed bleeding (P = 0.43) or overall 30-day infection rates (P = 0.66). After aspiration, gallbladder perforation rates may be lower. This does not appear to translate into decreased loss of gallstones or infection rates. There was no significant difference between techniques in blood loss from the liver bed. Further randomized, controlled trials and follow-up studies are required to confirm these results and to establish long-term sequelae.

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Free intra-peritoneal gall-stones following laparoscopic cholecystectomy

Cited by 16 publications

References 5 publications

The spilled stone

The spilled stone

The outcome of unretrieved gallstones in the peritoneal cavity during laparoscopic cholecystectomy

A Meta-analysis of Outcomes After Routine Aspiration of the Gallbladder During Cholecystectomy

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