ReviewLost gallstones in laparoscopic cholecystectomy: all possible complications
Section snippets
Methods
A systematic literature search in the NCBI National Library of Medicine (Pub Med; January 1987–January 2005) was conducted by the senior author (J.Z.). As mentioned in Brockmann et al [1], a systemic review according to the Cochrane recommendations is not possible because of the limitations of the primary literature.
A search strategy was set up using the following text words and combinations (Boolean operators): abscess, bile, fistula, lost gallstones, spilled gallstones, spilt gallstone,
List of possible complications
A total of 111 case reports and studies were found with documented complications after gallstone spillage or lost gallstones after LC. A list of possible complications categorized alphabetically with the references as mentioned in MEDLINE was created (Table 1). The most frequently reported complication was an abscess in the abdominal wall as a consequence of lost gallstones, which was mentioned in 16 case reports or studies. Intra-abdominal abscess was mentioned in 15 publications. Also,
Comments
The aim of the study was to perform a systemic literature search in order to alphabetically categorize complications of lost gallstones from LC. We found that the most published complications, like intra-abdominal abscesses and abscesses of the abdominal wall, followed by subhepatic and subphrenic abscesses, are likely the most frequent ones.
Another common complication is fistula formation, which occurs across a broad spectrum, ranging from fistulas of the skin or umbilicus to colocutaneous or
Summary
Lost gallstones have a low incidence of causing complications but have a large variety of different postoperative problems. Every effort should be made to remove spilled gallstones to prevent further complications, but conversion is not mandatory. Open or laparoscopic removal of lost gallstones with abscess formation should be preferred to interventional drainage. [29], [30], [31], [32], [35], [36].
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