J Korean Surg Soc.  2010 Jan;78(1):66-69. 10.4174/jkss.2010.78.1.66.

Percutaneous Removal of Spilled Gallstones after Laparoscopic Cholecystectomy

• Park JI
• Hur CY
• Kim JS
• Kim KH
• Kim KH
• Park OH
• Choi CS
• Choi YK

• KMID: 1775449
• DOI: http://doi.org/10.4174/jkss.2010.78.1.66

Abstract

Gallbladder perforation during laparoscopic cholecystectomy (LC) with spillage of bile and gallstones occurs frequently, but clinical sequelae caused by dropped gallstones are uncommon. We present a case of subhepatic and right-back abscess formation due to spilled gallstones occurring two years after LC, which were successfully removed using a percutaneous method as a minimally invasive technique. The patient firstly visited a primary care physician with right-back mass that was increasing in size and becoming symptomatic, then underwent incision and drainage. He was referred to our hospital and the subhepatic and right-back inflammatory mass containing spilled gallstones was revealed by computed tomography. Under fluoroscopic control, a percutaneous drainage catheter was placed within the abscess and pus was aspirated. The spilled gallstones were successfully retrieved with basket forceps, thereafter. The patient was discharged without significant complications on the 9th day after the percutaneous stone removal.

Keyword

Spilled gallstone; Laparoscopic cholecystectomy; Abscess; Percutaneous removal

MeSH Terms

Abscess
Bile
Catheters
Cholecystectomy, Laparoscopic
Drainage
Gallstones
Humans
Physicians, Primary Care
Suppuration
Surgical Instruments

Figure

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  Fig. 1 Abdominal CT scan shows the subhepatic abscess containing spilled gallstone.

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  Fig. 2 CT scan shows the inflammatory mass involving the rightback containing a spilled gallstone (arrow).

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  Fig. 3 Tubography after insertion of pigtail drainage catheter shows spilled gallstones adjacent to the catheter (arrow).

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  Fig. 4 Radiography shows the wire basket to remove the spilled gallstones within the stone basket sheath that was placed earlier.

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