Abdominal abscess from gallstones spilled at laparoscopic cholecystectomy. Case report and review of the literature.
One case is reported and 14 others are culled from the literature. Each patient experienced an intraperitoneal abscess with a gallstone nidus following laparoscopic cholecystectomy. Each required open surgical drainage weeks or months after the initial laparoscopic cholecystectomy. The natural biology of spilled intraperitoneal gallstones is not known. Two short-term animal studies suggest initial partial lysis and fibrotic encapsulation. At least 15% of completed laparoscopic cholecystectomies leave intraperitoneal gallstones. Almost all prove to be clinically innocuous but the rare instances of later intraabdominal abscess formation deserve recognition and reporting.
Shocket
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VA Medical Center, Bay Pines, FL 33504, USA.
D018784:Abdominal Abscess / Q000209:etiology*; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery; D006801:Humans; D007710:Klebsiella Infections / Q000209:etiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008297:Male