title: Gallstone abscess as a result of dropped gallstones during laparoscopic cholecystectomy.
abstract: BACKGROUND
  With the advent of laparoscopic cholecystectomy we have seen a "disease of medical progress" (DOMP). Herein we report a complication that developed 7 years after laparoscopic cholecystectomy.
  
  
  METHODS
  A 42 year old woman presented with worsening right-sided pain and tenderness. Seven years prior she underwent a laparoscopic cholecystectomy. Computed tomography demonstrated a subhepatic retroperitoneal inflammatory mass. On open exploration a 4cm×6cm retroperitoneal mass was excised. The mass contained purulent material and gallstones.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy has become the "gold standard" for the treatment of symptomatic gallstones. Prior to laparoscopic cholecystectomy there was no body of literature about lost gallstones thus making this a DOMP. In contrast, it is reported that as many as 5.4-19% of laparoscopic cholecystectomies have stones spilled with variable rates of retrieval. Our case demonstrates an extreme example of a complication resulting seven years after a laparoscopic cholecystectomy with gallstones left behind.
  
  
  CONCLUSIONS
  Recognizing that gallstones will be lost during some cases of laparoscopic cholecystectomy, we must remain vigilant and make a full attempt to retrieve all stones to prevent such rare but not insignificant potential complications.
authors.affiliation: Department of Vascular Surgery, Staten Island University Hospital, 256 Mason Ave, Building B, Staten Island, NY 10305, USA.
authors.forename: Kuldeep
authors.initials: K
authors.lastname: Singh
authors.forename: Ming L
authors.initials: ML
authors.lastname: Wang
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ofori
authors.forename: Warren
authors.initials: W
authors.lastname: Widmann
authors.forename: Aziz
authors.initials: A
authors.lastname: Alemi
authors.forename: Miles
authors.initials: M
authors.lastname: Nakaska