Wolf in sheep's clothing: spilled gallstones can cause severe complications after endoscopic surgery : Case report and review of literature

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Item Type:	Review
Title:	Wolf in sheep's clothing: spilled gallstones can cause severe complications after endoscopic surgery : Case report and review of literature
Creators Name:	Gretschel, S., Engelmann, C., Estevez-Schwarz, L. and Schlag, P.M.
Abstract:	Bile concrements may remain intraperitoneally after laparoscopic cholecystectomy. Previously, this was considered harmless, a view supported by some experimental studies. Recently, however, spilled gallstones have been identified as a source of rare but potentially serious complications. We report a case of a retrohepatic abscess and dorsal fistulation after laparoscopic cholecystectomy. Healing was achieved only by repeated surgery, including abscess drainage, stone removals, and fistula excision. Since 1990, 73 cases with gallstone-related complications after laparoscopic cholecystectomy have been reported in the literature. Among these complications, intra-abdominal abscesses and transabdominal fistulas were predominant. The interval between the cholecystectomy and the appearance of complications ranged from 4 days to 29 months, with a peak incidence at 4 months. Spillage of small bile concrements or fragments is, with the exception of multiple irremovable stones, not commonly an indication for conversion to an open procedure. However, the patient needs to be warned about the risk of gallstone loss and its associated complications at the time when informed consent is obtained. Furthermore, if gallstone loss has occurred, the patient should be informed, and the occurrence should be documented.
Keywords:	Complications, Laparoscopic Cholecystectomy, Spilled Gallstones
Source:	Surgical Endoscopy
ISSN:	0930-2794
Publisher:	Springer
Volume:	15
Number:	1
Page Range:	98
Date:	January 2001
Official Publication:	https://doi.org/10.1007/s004640040035
PubMed:	View item in PubMed

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