Dropped Gallstone-Related Right Subhepatic and Parietal Wall Abscess: A Rare Complication After Laparoscopic Cholecystectomy

Introduction Complications secondary to spilled gallstones can be classified in the category of disease of medical progress because prior to advent of laparoscopic cholecystectomy very few reports published on the topic. The aim of the present study was to investigate the predisposing factors and the complication rate of spilled gallstones during laparoscopic cholecystectomy over the past 21 years. Methods Embase, Pubmed, Medline, Google scholar and Cochrane library were systematically searched for pertinent literature. Results Seventy five out of 181 articles were selected including 85 patients; of those 38% were men and 62% women. The median age of the cohort was 64 years old and ranged between 33 and 87 years. Only 23(27%) of the authors reported the incident of spillage of the gallstones during the operation. Time of onset of symptoms varied widely from the second postoperative day to 15 years later. Ten of 85 patients were asymptomatic and diagnosed with spilled gallstones incidentally. The rest of the patients presented with complications of severe morbidity and almost, 87% of the patients needed to be treated with surgical intervention and 12% with US ± CT scan guidance drainage. Only one perioperative death reported. Conclusions Symptomatic patients with lost gallstones present with severe morbidity complications and required mostly major surgical procedures. Therefore, standardisation of the management of spilled gallstones is needed urgently. Hospitals need to review their policy with audits and recommendations and clinical guidelines are needed urgently.

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“…Seventy-five articles from a pool of 181 articles were selected including 85 patients [ 11 – 85 ], (Fig. 1 , Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Consequences of the spilled gallstones during laparoscopic cholecystectomy: a systematic review

et al. 2022

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“…Gallstones that have been spilled are usually clinically silent and considered harmless [5]. However, spilled gallstones may result in late complications of laparoscopic cholecystectomy, such as intraabdominal abscesses, abdominal wall abscesses, intra-thoracic abscesses, retroperitoneal abscesses, and pelvic abscesses [6][7][8]. There is little research on thoracic complications caused by residual gallstones after laparoscopic cholecystectomy [9,10].…”

Section: Discussionmentioning

confidence: 99%

A Case of Intractable Lung Abscess Following Dropped Gallstone-Induced Subphrenic Abscess: A Rare Postoperative Complication Caused by Dropped Gallstone During Laparoscopic Cholecystectomy

Nagata¹,

Fujikawa²,

Oka³

et al. 2022

Cureus

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Dropped gallstones into the abdominal cavity due to perforation of the gallbladder occasionally occur during laparoscopic cholecystectomy. Abscess formation caused by residual gallstones is one of the late postoperative complications after laparoscopic cholecystectomy. Most of them are intra-abdominal abscesses; however formation of intra-thoracic abscesses, in particular, lung abscess, is less described, and surgery for an intra-thoracic abscess is rarely performed. We describe a case of intractable lung abscess following dropped gallstone-induced subphrenic abscess caused by a residual gallstone after laparoscopic cholecystectomy.

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“…They excluded immunocompromised patients, patients on immunosuppressive therapy, those having preoperative fever and associated choledocholithiasis. 17 Ray et al found that gallbladder perforation and stone spillage is a common intraoperative problem during laparoscopic cholecystectomy. The incidence of lost or unretrieved stones is approximately 2%, and very few patients may develop complication.…”

Section: Limitationsmentioning

confidence: 99%

Post operative effect of bile spillage in laparoscopic cholecystectomy

Ranjan

Bhar²,

Parvej³

et al. 2023

Int Surg J

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Background: Most common disease of gall bladder and biliary tree is cholelithiasis. Laparoscopic cholecystectomy is now gold standard treatment. Gall bladder contents can be spilled during both in open and laparoscopic cholecystectomy, but these contents are eliminated usually through direct removal, copious irrigation and mopping in open operations. Right shoulder tip pain is a common short term complaint. Aims and objectives were to study right shoulder tip pain, its duration and severity in post-operative period of patients having spillage versus non spillage of gall bladder contents. Method: It is a hospital based prospective comparative study was conducted in KPC medical college and hospital, Jadavpur, Kolkata. Time frame was April 2021- July 2022. Sample size was 100. Result: Our study showed that, less number of patients had right shoulder tip pain (in numerical rating scale) and requirement of rescue analgesia in case compared to control group. Conclusions: Right shoulder-tip pain, which may occur post-laparoscopic cholecystectomy, is variable in duration, severity and character and is more in spillage group.

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Dropped Gallstone-Related Right Subhepatic and Parietal Wall Abscess: A Rare Complication After Laparoscopic Cholecystectomy

Cited by 9 publications

References 10 publications

Consequences of the spilled gallstones during laparoscopic cholecystectomy: a systematic review

Consequences of the spilled gallstones during laparoscopic cholecystectomy: a systematic review

A Case of Intractable Lung Abscess Following Dropped Gallstone-Induced Subphrenic Abscess: A Rare Postoperative Complication Caused by Dropped Gallstone During Laparoscopic Cholecystectomy

Post operative effect of bile spillage in laparoscopic cholecystectomy

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