Spilled gall stones during laparoscopic cholecystectomy: a review of the literature

Sathesh-Kumar, T; Saklani, Avanish; Vinayagam, Ragu; Blackett, R. L.

doi:10.1136/pmj.2003.006023

Cited by 126 publications

(163 citation statements)

References 34 publications

(12 reference statements)

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“…Such spillage are usually detected instantly, where in the ideal approach would be laparoscopic stone removal with thorough lavage. Need for conversion to open procedure for spilled stones is debatable 1, since the incidence of complications arising from this is extremely low. Otherwise, spillage of stones may go undetected and present early in the first few days or weeks following surgery with intra‐abdominal abscesses, in the background of systemic sepsis.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…The next commonest complication of spilled gall stones is wound infections and parietal abscess with chronic discharging sinuses. Fistulization usually occurs as colo‐cutaneous or biliary‐cutaneous fistulae 1, 4.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Literature reports an overall incidence of spilled stones as 5–40%, but causing morbidity in only about 0.08–0.3% of cases 1. While majority of these cases present as intra‐abdominal abscess requiring drainage, only few present with persistent discharging peritoneo‐cutaneous fistula.…”

Section: Introductionmentioning

confidence: 99%

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Peritoneo‐cutaneous fistula from spilled gall bladder calculus following laparoscopic cholecystectomy

Kumar

2017

Clinical Case Reports

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

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Peritoneo‐cutaneous fistula from spilled gall bladder calculus following laparoscopic cholecystectomy

Kumar

2017

Clinical Case Reports

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“…The abscess cavity was treated in the conventional manner by light gauze packing and dressing. The patient made an uneventful recovery and continues to be well in a follow-up of 3 months.Gallstone spillage has been reported in about 6-30 % of patients undergoing laparoscopic cholecystectomy [1]. In the majority of the patients, this is inconsequential.…”

mentioning

confidence: 99%

“…Gallstone spillage has been reported in about 6-30 % of patients undergoing laparoscopic cholecystectomy [1]. In the majority of the patients, this is inconsequential.…”

mentioning

confidence: 99%

Spilled Gallstone: Late Presentation

Ibrarullah

Modi²

2013

Indian J Surg

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Spilled gallstone, in a female patient, presented with an abscess 2 years after laparoscopic cholecystectomy. Computerized tomography scan of the abscess cavity containing the spilled stone that clinched the diagnosis has been presented. Keywords Laparoscopic cholecystectomy . Gallstone . ComplicationsA 39-year-old female presented with pain in the upper abdomen and fever of 1 week duration. She had undergone laparoscopic cholecystectomy about 2 years back for symptomatic cholelithiasis. Details of the cholecystectomy were not available. She apparently had an uneventful recovery. On examination, she was found to have localised induration and tenderness in the epigastrium. An ultrasound examination of the abdomen revealed localised fluid collection below the parietes and an echogenic focus within casting posterior acoustic shadow. She was subjected to contrast-enhanced computerized scan (CECT) of the abdomen. The CECT showed a thick-walled cavity between the anterior surface of the liver and parietes, containing approximately 50 ml of thick fluid suggestive of pus. A hyperdense, calcified object was seen in the centre of the abscess cavity ( Figs. 1 and 2). A clinical diagnosis of spilled gallstone in an abscess cavity was made and the patient was subjected to surgical exploration through a small subxiphoid incision. The abscess cavity was encountered between the parietes and anterosuperior surface of the right lobe of the liver. Approximately 50 ml of turbid fluid was drained out. Finger exploration of the abscess cavity revealed a pigmented gallstone. The abscess cavity was treated in the conventional manner by light gauze packing and dressing. The patient made an uneventful recovery and continues to be well in a follow-up of 3 months.Gallstone spillage has been reported in about 6-30 % of patients undergoing laparoscopic cholecystectomy [1]. In the majority of the patients, this is inconsequential. When symptomatic, it may present as abscess, sinus or fistula formation. The interval between cholecystectomy and onset of the symptoms can range from perioperative period to as late as 20 years [2]. Diagnosis is more often postoperative, following retrieval of the offending stone. In our patient, a correct preoperative diagnosis could be made on the basis of imaging findings.

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Comparison of Systematic Video Documentation With Narrative Operative Report in Colorectal Cancer Surgery

et al. 2019

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IMPORTANCE Despite ongoing advances in the field of colorectal surgery, the quality of surgical treatment is still variable. As an intrinsic part of surgical quality, the technical information regarding the surgical procedure is reflected only by the narrative operative report (NR), which has been found to be subjective and regularly omits important information. OBJECTIVE To investigate systematic video recording (SVR) as a potential improvement in quality and safety with regard to important information in colorectal cancer surgery. DESIGN, SETTING, AND PARTICIPANTS The Imaging for Quality Control Trial was a prospective, observational cohort study conducted between January 12, 2016, and October 30, 2017, at 3 centers in the Netherlands. The study group consisted of 113 patients 18 years or older undergoing elective laparoscopic surgery for colorectal cancer. These patients were case matched and compared with cases from a historical cohort that received only an NR. INTERVENTIONS Among study cases, participating surgeons were requested to systematically capture predefined key steps of the surgical procedure intraoperatively on video in short clips. MAIN OUTCOMES AND MEASURES The SVRs and NRs were analyzed for adequacy with respect to the availability of important information regarding the predefined key steps. Adequacy of the reported information was defined as the proportion of key steps with available and sufficient information in the report. Adequacy of the SVR and NR was compared between the study and control groups, with the SVR alone and as an adjunct to the NR in the study group vs NR alone in the control group. RESULTS Of the 113 study patients, 69 women (61.1%) were included; mean (SD) age was 66.3 (9.8) years. In the control group, a mean (SD) of 52.5% (18.3%) of 631 steps were adequately described in the NR. In the study group, the adequacy of both the SVR (78.5% [16.5%], P < .001) and a combination of the SVR with NR (85.1% [14.6%], P < .001) was significantly superior to NR alone. The only significant difference between the study and historical control groups regarding postoperative and pathologic outcomes was a shorter postoperative mean (SD) length of stay in favor of the study group (8.0 [7.7] vs 8.6 [6.8] days; P = .03). CONCLUSIONS AND RELEVANCE Use of SVR in laparoscopic colorectal cancer surgery as an adjunct to the NR might be superior in documenting important steps of the operation compared with NR alone, adding to the overall availability of necessary intraoperative information and contributing to quality control and objectivity.

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Spilled gall stones during laparoscopic cholecystectomy: a review of the literature

Cited by 126 publications

References 34 publications

Peritoneo‐cutaneous fistula from spilled gall bladder calculus following laparoscopic cholecystectomy

Peritoneo‐cutaneous fistula from spilled gall bladder calculus following laparoscopic cholecystectomy

Spilled Gallstone: Late Presentation

Comparison of Systematic Video Documentation With Narrative Operative Report in Colorectal Cancer Surgery

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