Lost Stones During Laparoscopic Cholecystectomy

Diez, J.; Arozamena, C. J.; Gutierrez, Leopoldo S.; Bracco, J.; Mon, Ami; Almeyra, R. Sanchez; Secchi, Mf

doi:10.1155/1998/95874

Cited by 59 publications

(90 citation statements)

References 15 publications

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“…Gallbladder perforation during dissection from the liver bed with spillage of bile and loss of stones in the peritoneal cavity is a common operative problem during laparoscopic cholecystectomy. 1 The incidence of gallbladder perforation during laparoscopic cholecystectomy has been reported to be 20%-40%. 2,3 During surgery, gallbladder perforation with spillage of bile and loss of stones disrupts the flow of surgery and prolongs its duration.…”

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confidence: 99%

Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

et al. 2012

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RESEARCH • RECHERCHEMonopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial Background: Ultrasonic dissection has been suggested as an alternative to monopolar electrocautery in laparoscopic cholecystectomy because it generates less tissue damage and may have a lower incidence of gallbladder perforation. We compared the 2 methods to determine the incidence of gallbladder perforation and its intraoperative consequences. Methods:We conducted a prospective randomized controlled trial between July 2008 and December 2009 involving adult patients with symptomatic gall stone disease who were eligible for laparoscopic cholecystectomy. Patients were randomly assigned before administration of anesthesia to electrocautery or ultrasonic dissection. Both groups were compared for incidence of gallbladder perforation during dissection, bile leak, stones spillage, lens cleaning, duration of surgery and estimation of risk of gallbladder in the presence of complicating factors. Results:We included 60 adult patients in our study. The groups were comparable with respect to demographic characteristics, symptomatology, comorbidities, previous abdominal surgeries, preoperative ultrasonography findings and intraoperative complications. The overall incidence of gallbladder perforation was 28.3% (40.0% in the electrocautery v. 16.7% in the ultrasonic dissection group, p = 0.045). Bile leak occurred in 40.0% of patients in the electrocautery group and 16.7% of patients in ultrasonic group (p = 0.045). Lens cleaning time (p = 0.015) and duration of surgery (p = 0.001) were longer in the electrocautery than the ultrasonic dissection group. There was no statistical difference in stone spillage between the groups (p = 0.62). Conclusion:Ultrasonic dissection is safe and effective, and it improves the operative course of laparoscopic cholecystectomy by reducing the incidence of gallbladder perforation.

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confidence: 99%

Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

et al. 2012

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“…Considering these severe consequences, most surgeons prefer to find and remove all retained stones as well as surgical clips. Some studies have yet recommended a conversion to laparotomy in special cases with multiple pigment stones (9,10). On the other hand, several experimental studies supporting the idea that the dropped gallstones do not cause a great problem, believe to leave them after washing the abdomen with a saline solution and performing an antibiotic treatment (11,12).…”

Section: Discussionmentioning

confidence: 99%

Giant gallstone in abdominal wall: a rare complication of laparoscopic cholecystectomy

Yigitler¹,

Duman²,

Özcan³

2013

Gaziantep Med J

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We aim to report a case of abdominal wall mass formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy (LC). A 73-year-old women presented with purulent discharge from one of her previous port sites one year after she underwent LC. The latter revealed a round opaque mass in an abscess like cavity, and subsequently an ultrasonography showed a round echogenity with acoustic shadow posteriorly. Axial CT images verified the presence of a well-circumscribed hyperdensity which was really a gallstone in a cystic mass. To reduce this complication, excessive traction of the gallbladder should be avoided during dissection. Prior to extraction, gallbladder contents should be aspirated, and to extract larger stones. In the event of perforation occurring, the gallbladder should be placed in a plastic bag, spilled stones should be retrieved where possible and excessive irrigation used to remove the bile.

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“…Some of these complications are not so significant, while some others are very significant which include abscess in the abdominal wall, broncholithiasis, stone expectoration, cellulites, dyspareunia, erosion to the back, fat necrosis posterior of the rectus muscle, fever, fistula formation, gallstone granuloma, gluteal abscess, granulomatous peritonitis mimicking endometriosis, ileus, intestinal obstruction, implantation malignancy, incarcerated hernia, intra-abdominal abscess, jaundice, liver abscess mimicking malignancy, middle colic artery thrombosis, mimicking acute appendicitis, paracolic abscess, paraumbilical tumor, peritoneal abscess formation, pelvic abscess, pelvic stones, peritonitis, pleural empyema, fluid collections, pneumonia, port site stones, port site abscess, recurrent staphylococcal bacteremia, retrohepatic abscess, retroperitoneal abscess, retroperitoneal actinomycosis, right flank abscess, small bowel obstruction, stones in gastrocolic omentum, stones in hernia sac, stones of the ovary, stone of the fallopian tube, subhepatic abscess, subphrenic abscess, thoracoabdominal mycosis, trans diaphragmatic abscess, umbilical wound abscess, and vesical granuloma [3,4,[9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it makes a significant problem. The variety of complications caused by lost gallstones [3][4][5] may range from simple surgical site infection to more serious forms like broncholithiasis.…”

Section: Introductionmentioning

confidence: 99%

“…This incidence increases by greater than twofold when the stones are unretrieved [3]. A prospective collection of data was obtained in accordance with the pro forma which documented patients' details, diagnosis, preoperative physical and ultrasound abdomen findings, intraoperative details such as technique, spillage of stones, cause for spillage, method and port of extraction of specimen, duration of surgery and postoperative events, and complications.…”

Section: Introductionmentioning

confidence: 99%

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Consequences of Spilt Gallstones During Laparoscopic Cholecystectomy

Virupaksha

2012

Indian J Surg

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To document the incidence of spilt gallstones during laparoscopic cholecystectomy, the cause and consequences of such spillage. The study included 150 consecutive laparoscopic cholecystectomies performed between October 2007 and November 2008. Data was collected in a prospective manner in accordance to proforma. Follow up were performed at the end of 1 week, 1 month, 6 months and 1 year. The 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. The 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 Dasari and Loan (JSLS 13(1):73-76, 2009), Daradkeh and Suwan (World J Surg 22:75-77, 1998).

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Lost Stones During Laparoscopic Cholecystectomy

Cited by 59 publications

References 15 publications

Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

Giant gallstone in abdominal wall: a rare complication of laparoscopic cholecystectomy

Consequences of Spilt Gallstones During Laparoscopic Cholecystectomy

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