Remote complications of spilled gallstones during laparoscopic cholecystectomy: causes, prevention, and management.
In the last 11 years (November 1989-December 2000), 5526 laparoscopic cholecystectomies were performed in a community residency training program. Two cases (0.04%) of remote complications secondary to spilled gallstones were identified. A 75-year-old woman presented with a sterile abscess in the abdominal wall containing gallstones 4 years and 4 months after an elective laparoscopic cholecystectomy. The second patient, a 43-year-old woman, presented with a subdiaphragmatic/subhepatic abscess containing gallstones. The abscess grew the same bacteria that were present 2 years and 3 months previously during a laparoscopic cholecystectomy for acute gangrenous cholecystitis. In both cases, pigmented gallstones were identified. Causes of gallstone spillage, means of prevention, and ways of managing this complication are discussed.
Hawasli
Abdelkader
A
Department of Surgery, St. John Hospital & Medical Center, Detroit, Michigan, USA.
Schroder
Donn
D
Rizzo
Joseph
J
Thusay
Manish
M
Takach
Thomas J
TJ
Thao
Umeng
U
Goncharova
Irina
I
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000209:etiology*; D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002764:Cholecystitis / Q000382:microbiology / Q000601:surgery; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000209:etiology; D007711:Klebsiella pneumoniae; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed