Intraoperative gallbladder perforation and risk of postoperative abscess with or without antibiotics: national cohort study of more than 108 000 cholecystectomies

No significant persistent symptoms from gallstones left in the abdomen after cholecystectomy

INTRODUCTION

Perforation of the gallbladder during cholecystectomy can lead to spillage of gallstones. The aim of this study was to examine if patients with gallstones left in the abdomen after cholecystectomy suffer persisting symptoms.

METHOD

This study was based on data from the Swedish Register for Gallstone Surgery. Patients with intraoperative gallbladder perforation where it is suspected that gallstones remain in the abdomen were matched with patients that had undergone a cholecystectomy with no suspicion of spilled gallstones. All patients were sent a validated questionnaire including 21 items concerning abdominal pain and inflammatory symptoms. Items were divided into four groups: abdominal pain, consequences of pain, gastrointestinal symptoms, and repeated operation. Mean scores were compared between the study group and the control group using a linear regression model.

RESULTS

The questionnaire was sent to 4269 subjects, and the response rate was 66 %. No significant differences were seen between the study and control groups in the four domains. In the repeated operation domain, 7.1 % in the study group and 5.3 % in the control group underwent a repeated operation (p = 0.057).

CONCLUSION

Gallstones left in the abdomen are not associated with long-term symptoms. There was a tendency towards a repeat operation in the group that suffered perforation of the gallbladder, although this finding was not significant.