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Spontaneous erosion of a lost intra-abdominal gallstone through the back eight months following laparoscopic cholecystectomy.

Memon MA, Jenkins HJ, Fitzgibbons RJ - JSLS (1997 Apr-Jun)

Bottom Line: The purpose of this study was to determine the incidence of this complication in our patients.The number of perforations resulting in loss of stones in the abdominal cavity was 16% (165 patients).Of these 165 patients, only a single patient could be identified as having a long-term complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131, USA.

ABSTRACT

Background and objectives: Gallbladder perforation during laparoscopic cholecystectomy with spillage of bile and gallstones occurs in up to 40% of patients. Several reports have recently been published describing complications related to these lost gallstones. The purpose of this study was to determine the incidence of this complication in our patients.

Methods: A prospectively maintained database of 856 laparoscopic cholecystectomies performed between 1989 and 1996 by a single surgeon was analyzed.

Results: The number of perforations resulting in loss of stones in the abdominal cavity was 16% (165 patients). Of these 165 patients, only a single patient could be identified as having a long-term complication.

Conclusions: Intra-abdominal lost gallstones can produce complications secondary to migration and erosion. It is prudent to make a concerted effort to remove spilled gallstones by every possible means but conversion to laparotomy is not justifiable.

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Related in: MedlinePlus

Repeat CT scan of the abdomen two months later showing changes around the gallbladder bed indicating an inflammatory type process (arrow) although no definite fluid collection can be seen.
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Figure 5: Repeat CT scan of the abdomen two months later showing changes around the gallbladder bed indicating an inflammatory type process (arrow) although no definite fluid collection can be seen.

Mentions: After discharge, the patient continued to experience intermittent low-grade pyrexia and abdominal pain. A repeat CT scan of the abdomen two months later revealed changes around the gallbladder bed indicating an inflammatory process although no definite fluid collection was noted (Figure 5). He was once again treated conservatively with oral antibiotics, Augmentin 500 mg tid with improvement in his temperature, albeit temporarily.


Spontaneous erosion of a lost intra-abdominal gallstone through the back eight months following laparoscopic cholecystectomy.

Memon MA, Jenkins HJ, Fitzgibbons RJ - JSLS (1997 Apr-Jun)

Repeat CT scan of the abdomen two months later showing changes around the gallbladder bed indicating an inflammatory type process (arrow) although no definite fluid collection can be seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3021273&req=5

Figure 5: Repeat CT scan of the abdomen two months later showing changes around the gallbladder bed indicating an inflammatory type process (arrow) although no definite fluid collection can be seen.
Mentions: After discharge, the patient continued to experience intermittent low-grade pyrexia and abdominal pain. A repeat CT scan of the abdomen two months later revealed changes around the gallbladder bed indicating an inflammatory process although no definite fluid collection was noted (Figure 5). He was once again treated conservatively with oral antibiotics, Augmentin 500 mg tid with improvement in his temperature, albeit temporarily.

Bottom Line: The purpose of this study was to determine the incidence of this complication in our patients.The number of perforations resulting in loss of stones in the abdominal cavity was 16% (165 patients).Of these 165 patients, only a single patient could be identified as having a long-term complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131, USA.

ABSTRACT

Background and objectives: Gallbladder perforation during laparoscopic cholecystectomy with spillage of bile and gallstones occurs in up to 40% of patients. Several reports have recently been published describing complications related to these lost gallstones. The purpose of this study was to determine the incidence of this complication in our patients.

Methods: A prospectively maintained database of 856 laparoscopic cholecystectomies performed between 1989 and 1996 by a single surgeon was analyzed.

Results: The number of perforations resulting in loss of stones in the abdominal cavity was 16% (165 patients). Of these 165 patients, only a single patient could be identified as having a long-term complication.

Conclusions: Intra-abdominal lost gallstones can produce complications secondary to migration and erosion. It is prudent to make a concerted effort to remove spilled gallstones by every possible means but conversion to laparotomy is not justifiable.

Show MeSH
Related in: MedlinePlus