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Laparoscopic cholecystectomy is becoming increasingly popular in the treatment of symptomatic gallstones, offering improved patient satisfaction and decreased hospital stays. The authors describe a patient in whom infected bile and gallstones were spilled or "dropped" during laparoscopic cholecystectomy. Most of the gallstones ranged from 5 to 8 mm in diameter; one gallstone was 11 x 17 mm. An abscess formed around the stones, and percutaneous stone removal was performed 1 week after abscess drainage. The size of the retained gallstones is important. Stones smaller than 1 cm in diameter can usually be removed via a 30-F sheath by conventional means, whereas stones larger than 1 cm in diameter require fragmentation before removal.

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Percutaneous direct jejunostomy placement is a relatively safe and effective means of gaining enteral access in patients who have enterocutaneous fistula or who have either postsurgical or neoplastic changes of the stomach that preclude traditional gastrostomy placement.