Peritoneal gallstones following laparoscopic cholecystectomy: Incidence, complications, and management

• Published in: Surgical endoscopy Vol. 18; no. 8; pp. 1200 - 1207
• Main Authors: WOODFIELD, J. C, RODGERS, M, WINDSOR, J. A
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-08-2004; Springer Nature B.V
• Subjects: Abscess - etiology; Abscesses; Bile ducts; Biological and medical sciences; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Cysts; Gallbladder; Gallbladder - injuries; Gallstones; Gallstones - complications; Gallstones - surgery; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Laparoscopy; Liver; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Other diseases. Semiology; Peritoneal Diseases - etiology; Peritonitis - etiology; Cholecystectomy; Spilt gallstone; Perforation; Peritoneal gallstone; Laparoscopy; Biliary tract disease; Gallbladder perforation; Incidence; Medicine; Treatment; Laparoscopic cholecystectomy; Surgery; Digestive diseases; Complication; Gallbladder; Endoscopy; Peritoneum
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-003-8260-4

Gallstone spillage during laparoscopic cholecystectomy (LC) is a common intraoperative event. Although gallstones left in the peritoneal cavity were initially considered harmless, a significant number of complications have been reported. Our aim was to quantify the likelihood, and to document the range, of subsequent complications.
A Medline search from 1987 to January 2003 was performed. Articles with more than 500 LCs that quantified the frequency of complications due to peritoneal gallstones were reviewed, as were representative case studies of different stated complications.
Six studies, covering 18,280 LCs, were found. The incidence of gallbladder perforation was 18.3%, that of gallstone spillage was 7.3%, and that of unretrieved peritoneal gallstones was estimated to be 2.4%. There were 27 patients with complications. The likelihood of a complication when gallstone spillage occurred was 2.3%, which increased to 7.0% when unretrieved peritoneal gallstones were documented.
Spilt gallstones have a small but quantifiably real risk of causing a wide range of significant postoperative problems.