Published: 2019-08-28

Gall stone abscess, a delayed complication following laparoscopic cholecystectomy

Amaresh Aruni, Hemanth Kumar, Harjeet Singh, Satish Subbiah Nagaraj


In the current era of minimally invasive surgeries, laparoscopic cholecystectomy being the popular surgery for the symptomatic cholelithiasis and complications pertaining to these minimally invasive surgeries, here we report a complication related to gall stone spillage after 4 months of surgery in 80-year male patient presenting as abdomen lump. The risk of stone spillage and complications related to it are more than open cholecystectomy. Careful dissection, extraction and complete retrieval of all the spilled stones can avoid these complications and hence complication related to stone spillage can be potentially avoided, and intra-operative documentation of the gall stone spillage can help to think for early diagnosis and treatment of the complications.


Gall stone, Stone spillage, Laparoscopic cholecystectomy

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Zehetner J, Shamiyeh A, Wayand W. Lost gallstones in laparoscopic cholecystectomy: all possible complications. Am J Surg. 2007;193:73–8.

Kalid M, Rashid M. Gallstone abscess: a delayed complication of spilled gallstone after laparoscopic cholecystectomy. Emerg Radiol. 2009;16:227–9.

Schol FPG, Go PMNYH, Gouma DJ. Risk factors for bile duct injury in laparoscopic cholecystectomy: analysis of 49 cases. Br J Surg. 1994;81:1786–8.

Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy; a national survey of 4292 hospitals and an analysis of 77,604 cases. Am J Surg. 1993;165:9–14.

Offiah C, Robinson P, Keeling-Roberts CS. The one that got away. Br J Radiol. 2002;75:393–4.

Schafer M, Suter C, Klaiber C, Wehrli H, Frei E, Krahenbuhl L. Spilled gallstones after laparoscopic cholecystectomy: a relevant problem? A retrospective analysis of 10,174 laparoscopic cholecystectomies. Surgical Endoscopy. 1998;12(4):305–9.

Patterson EJ, Nagy AG. Don’t cry over spilled stones? Complications of gallstones spilled during laparoscopic cholecystectomy: case report and literature review. Can J Surg. 1997,40:300-4.

Brockmann JG, Kocher T, Senninger NJ, Schurmann GM. Complications due to gallstones lost during ¨laparoscopic cholecystectomy: an analysis of incidence, clinical course, and management. Surgical Endoscopy Other Interventional Techniques. 2002;16(8):226–1232.

Woodfield JC, Rodgers M, Windsor JA. Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management. Surgical Endoscopy Other Interventional Techniques. 2004;18(8):1200–7.

Sathesh-Kumar T, Saklani AP, Vinayagam R, Blackett RL. Spilled gall stones during laparoscopic cholecystectomy: a review of the literature. Postgraduate Med J. 2004;80(940):77–9.

Memon MA, Jenkins HJ Jr, Fitzgibbons RJ Jr. Spontaneous erosion of a lost intra-abdominal gallstone through the back eight months following laparoscopic cholecystectomy. J Society Laparo-endoscopic Surgeons. 1997;1(2):153–7.

Memon MA, Deeik RK, Maffi TR, Fitzgibbons RJ Jr. The outcome of un-retrieved gallstones in the peritoneal cavity during laparoscopic cholecystectomy: a prospective analysis. Surgical Endoscopy. 1999;13(9):848–57.

Zehetner J, Shamiyeh A, Wayand W. Lost gallstones in laparoscopic cholecystectomy: all possible complications. Am J Surg. 2007;193:73-8.

Morrin M, Kruskal J, Saldinger P, Kane R. Radiological features of complication arising from dropped gallstone in laparoscopic cholecystectomy patients. Am J Roentgenol. 2000;174:1441–5.

Van Brunt PH, Lanzafame RJ. Subhepatic inflammatory mass after laparoscopiccholecystectomy: a delayed complication of spilled gallstone. Arch Surg. 1994;129:882–93.

Hanna SJ, Barakat O, Watkin S. Chole-lithoptysis: an unusual delayed complication of laparoscopic cholecystectomy. J Hepato-Biliary-Pancreatic Surg. 2004;11(3):190–2.

Chopra P, Killorn P, Mehran RJ. Chole-lithoptysis and pleural empyema. Annals Thoracic Surg. 1999;68(1):254–5.