Surgical Endoscopy

, Volume 9, Issue 3, pp 344–347 | Cite as

Abdominal abscess from gallstones spilled at laparoscopic cholecystectomy

Case report and review of the literature
  • E. Shocket
Case reports

Abstract

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.

Key words

Spilled gallstones Abdominal abscess Laparoscopic cholecystectomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bowen JC, Brenner HL, Ferrante WA, Maule WF (1992) Gallstone disease pathophysiology, epidemiology, natural history and, treatment options. Med Clin North Am 76: 1143–1157Google Scholar
  2. 2.
    Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387Google Scholar
  3. 3.
    Deziel DJ, Millikin KW, Economou SG, Doolis A, Ko ST, Arian MC (1993) Pathic complications of laparoscopic cholecystectomy: national survey of 4,292 hospitals—an analysis of 77,604 cases. Am J Surg 165: 9–14Google Scholar
  4. 4.
    Donohue JH, Farnell MB, Grant CS, VanHerden JA, Wahlstrom HE, Sarr MG, Weaver AL, Ilstrup DM (1992) Laparoscopic cholecystectomy: early Mayo Clinic experience. Mayo Clin Proc 67: 449–455Google Scholar
  5. 5.
    Graves EJ (1994) 1991 Summary National Hospital Discharge Survey of Dept on HHS. Quoted by Diehl AK, Letter to editor. JAMA 271: 501Google Scholar
  6. 6.
    Kakani PR, Bhullar IS (1993) Complications of spilled gallstones during laparoscopic cholecystectomy. Contemp Surg 43: 357–361Google Scholar
  7. 7.
    Klar RM, Kongstvedt PR (1994) Letter to editor. JAMA 271: 500–501Google Scholar
  8. 8.
    Lee VS, Paulson EK, Libbey E, Flannery JE, Meyers WC, Gastroenterology (1993) Cholelithoptysis and cholelithorrata; rare complications of laparoscopic cholecystectomy. Gastroenterology 105: 1877–1881Google Scholar
  9. 9.
    Leland DG, Dawson DL (1993) Adhesions and experimental intraperitoneal gallstones. Contemp Surg 42: 273–276Google Scholar
  10. 10.
    Nicolai P-Foley RJ (1992) Letter to editor: complications of spilled gallstones. J Laparoendosc Surg 2: 362–363Google Scholar
  11. 11.
    Soper NJ, Dunnegan DL (1991) Does intraoperative gallbladder perforation influence the early outcome of laparoscopic cholecystectomy? Surg Laparosc Endosc 1: 156–161Google Scholar
  12. 12.
    Stewart L, Smith AL, Pelligrin CA, Motson RW, Way LN (1987) Pigment gallstones form a composite of bacterial microcolonies and pigment solids. Ann Surg 206: 242–250Google Scholar
  13. 13.
    Welch N, Hinder RA, Fitzgibbons Jr RJ, Rouse JW (1991) Gallstones in the peritoneal cavity. A clinical and experimental study. Surg Laparosc Endosc 1: 246–247Google Scholar
  14. 14.
    Zheutlin N, Lasser EC, Rigler LG (1952) Clinical studies on effect of barium in the peritoneal cavity following rupture of the colon. Surgery 12: 967–979Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • E. Shocket
    • 1
  1. 1.General SurgeryVA Medical CenterBay PinesUSA

Personalised recommendations