The consequences of lost gallstones during laparoscopic cholecystectomy

Laparoscopic cholecystectomy has become the preferred surgical technique for symptomatic gallstone disease. The technique generally is safe. Probably one of the most common intra-operative complications is gallbladder perforation with stones spreading into the peritoneal cavity. In this paper the sequelae of lost gallstones after laparoscopic cholecystectomy and the diagnostic problems facing the clinician are reviewed. Abscesses and fistula formation in the abdominal wall occur. A long delay can be present between the initial operation and the complications of the lost stones. Although rupture of the gallbladder is usually noticed during preparation and retrieval, the surgeon may not be aware of losing stones. Due to the long delay, the occurrence of intra-abdominal abscesses and fistula is often not linked to the prior procedure.