Kaplan U, Shpoliansky G, Abu Hatoum O, Kimmel B, Kopelman D. The lost stone - Laparoscopic exploration of abscess cavity and retrieval of lost gallstone post cholecystectomy: A case series and review of the literature.
Int J Surg Case Rep 2018;
53:43-45. [PMID:
30368124 PMCID:
PMC6203240 DOI:
10.1016/j.ijscr.2018.10.020]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/29/2018] [Accepted: 10/13/2018] [Indexed: 12/11/2022] Open
Abstract
Gallbladder perforation during laparoscopic cholecystectomy can cause late formation of intra-abdominal abscess.
Gallbladder perforation should be informed and documented.
We report a novel technique, using minimally invasive skills, to explore a small cavity of an abscess and retrieve lost gallstones.
Laparoscopic exploration of the abscess cavity is not only safe and feasible, but enables meticulous exploration of the abscess cavity.
Background
Laparoscopic cholecystectomy (LC) is considered the gold standard operation for symptomatic gallstones. Gallbladder perforation occurs in 6–40% of operations. It can lead to spillage of gallstones into the abdominal cavity with possible consequences of long-term complications. We report two cases where a unique use of laparoscopic technique was used to explore abscess cavity and retrieve lost gallstones without penetrating the peritoneal cavity.
Case presentation
We report two cases of peri-hepatic abscess treated with laparoscopic cavity exploration, using 5 mm and 10 mm ports, to retrieve lost gallstones. It was done without entering the peritoneal cavity.
Discussion
Today, minimally invasive technique is used in a variety of surgical cases. We report a novel technique, using laparoscopic skills, to drain abscesses caused by lost gallstones post LC without entering the peritoneal cavity. The use of minimally invasive surgery techniques in order to explore abscess cavities not only help us to extract the cause of the abscess but also prevents another surgery in the abdominal cavity.
Conclusion
Laparoscopic exploration of an abscess cavity is a feasible and safe technique treating long-term complications of gallbladder perforation post LC.
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