Laparoscopic cholecystectomy for giant gall stone: Report of two cases

Igwe, P.O.; Diri, O.N.

doi:10.1016/j.ijscr.2020.01.055

Cited by 11 publications

(14 citation statements)

References 13 publications

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“…5 Few other reports have been reported for giant gallstones. 6,7 We report two cases of patients with large/giant gallstones. In the first case, gallstone measured 4X3.3X3 cm and weighted 23.2 gm and in the second case, gallstone measured 5.2X3X2.8 cm and weighted 24.7 gm.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature

Shrestha¹,

Bhattarai²,

Shrestha³

et al. 2021

Nep. Mediciti Med. J.

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Gallstones disease are the most common biliary pathology. Its prevalence in Nepal is found to be 4.87%. Giant/large gallstones have a higher risk of complications and presents technical difficulties during laparoscopic cholecystectomy. Open cholecystectomy is preferred in most of the cases with giant gallstones. With the availability of experience laparoscopic surgeon and modern laparoscopic equipment, laparoscopic cholecystectomy is also feasible in large/giant gallstones. We report 2 cases, one large gallstone in 51 years old female and one giant gallstone in 39 years old female each of which were successfully managed laparoscopically with uneventful post-operative period.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature

Shrestha¹,

Bhattarai²,

Shrestha³

et al. 2021

Nep. Mediciti Med. J.

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“…In our study, classic open cholecystectomy was preferred as like as some other studies [6,9,11,12,14,15]. In giant gall stones, it is much difficult to do laparoscopic cholecystectomy, so conversion from laparoscopic to open cholecystectomy is often performed because the giant stones are associated with more inflammation and thickening of the gallbladder wall and could make it much more difficult to hold the gallbladder with a grasper and expose Calot's triangle anatomy and retrieve such a large gallstone [19,20]. Because of these whys and wherefores, open cholecystectomy is the ideal procedure in such cases [19].…”

Section: Discussionmentioning

confidence: 86%

“…Because of these whys and wherefores, open cholecystectomy is the ideal procedure in such cases [19]. However, this procedure is much difficult in these instances, but it is not an absolute indication for open cholecystectomy, and laparoscopy could be performed by an expert laparoscopic surgeon [20].…”

Section: Discussionmentioning

confidence: 99%

Cholecystomegaly: A Case Report and Review of the Literature

Jahantab

Salehi

Mehrabi

et al. 2020

Case Reports in Gastrointestinal Medicine

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Chronic cholecystitis or symptomatic gallbladder is a prolonged mechanical or functional disorder of abnormal gallbladder emptying. Most of the patients have recurrent pain attacks (acute biliary colic), but when pain lasts more than 24 hours, it requires urgent surgical intervention (acute cholecystitis). The length of a fully distended gallbladder is about 7 to 10 cm. We report a case of a huge and severely inflamed gallbladder, as we have just found only a few previous case reports of the huge gallbladder in the literature. This case report and review may help to find a mechanism for the development of a giant gallbladder. The patient was a 36-year-old woman, who had been known to have a symptomatic gallstone for at least three years. The patient underwent laparotomy, and a giant 22 cm roundish severely inflamed and overdistended gallbladder with wall thickening and tight adhesion to adjacent organs was found under the right liver lobe. Femininity and diabetes seem to be risk factors for developing a huge gallbladder, and several hypotheses are encountered: (1) a long-lasting obstructed cystic duct or biliary tree, and accumulation of mucosal secretion from the gallbladder epithelium, (2) an obstructed hepatic/cystic duct junction with a stone acting like a check valve and bile trapping mechanism, and (3) gallbladder dysfunction and cholecystoparesis affecting through reduced cholecystokinin and celiac parasympathetic nerve disturbance in diabetes and diabetic autonomic neuropathy. Open cholecystectomy is the technique of choice in surgical excision of a huge gallbladder; however, laparoscopy could be performed by expert hands.

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“…5 Few other reports have been reported for giant gallstones. 6, 7 We report two cases of patients with large/giant gallstones. In the rst case, gallstone measured 4*3.3*3 cm and weighted 23.2 gm and in the second case, gallstone measured 5* 3*2.8 cm and weighted 24.7 gm.…”

Section: Discussionmentioning

confidence: 97%

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature.

Shrestha

Bhattarai

Shrestha

et al. 2021

Preprint

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Background Gallstones disease (GSD) is the most common biliary pathology. GSD is one of the common surgical problems in which lead people admit to the hospital in Nepal. Its prevalence is found to be 4.87%. The size of a gallstone is important, as giant/large gallstones have a higher risk of complications and present technical difficulties during laparoscopic cholecystectomy (LC). Open cholecystectomy is preferred in most cases with giant gallstones. With the availability of experienced laparoscopic surgeons and modern laparoscopic equipment LC is also feasible in large/giant gallstones. In this case report, we report 2 cases of one large and one giant gallstone each which were successfully done laparoscopically.Case Presentation Case 1 A 51 years old female presented with 5 months history of intermittent right upper quadrant colicky pain related to fatty food with no significant past medical and surgical history.Ultrasound abdomen showed normal gallbladder with multiple gallstones, largest measuring approximately 4cms. She was planned for elective LC. The gallbladder was removed out after extension of the infra-umbilical incision. On the cut section, we found multiple gallstones with one large gallstone measuring 4*3.3*3 cm and weighted 23.2 gm. Her post-operative period was uneventful. Case 2 A 39 years old female, known case of hypertension under calcium channel blocker(CCB) and angiotensin receptor blocker(ARBs) presented with 5 months history of intermittent right upper quadrant colicky pain related to fatty foods with non-significant surgical history. Ultrasound abdomen showed a normal gallbladder with a single large gallstone (approximately 4.7 cm). Elective LC was performed and the gallbladder was removed out after extension of infraumbilical incision. On the cut section, we found a single giant gallstone measuring 5* 3*2.8 cm and weighted 24.7 gm. Her post-operative period was uneventful.Conclusion Large/giant gallstones are associated with a high risk of complications and cholecystectomy is warranted in symptomatic and asymptomatic patients. Even for large/giant gallstones, LC appears to be the treatment of choice over open cholecystectomy and should be performed by an experienced laparoscopic surgeon, taking into consideration the possibility of conversion to open in case of inability to expose the anatomy and any intraoperative technical difficulties.

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Laparoscopic cholecystectomy for giant gall stone: Report of two cases

Cited by 11 publications

References 13 publications

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature

Cholecystomegaly: A Case Report and Review of the Literature

Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature.

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