J Minim Invasive Surg.  2024 Mar;27(1):51-54. 10.7602/jmis.2024.27.1.51.

Chronic abdominal wall sinus secondary to missed spilled gallstones in laparoscopic cholecystectomy: a harrowing experience

• Aitha S
• Sasmal PK
• Kumar P
• Challawar R
• Sinha M

• KMID: 2554126
• DOI: http://doi.org/10.7602/jmis.2024.27.1.51

Abstract

Gallbladder perforation with spillage of gallstones is not uncommon during laparoscopic cholecystectomy. Stone spillage can cause several complications. We report a case of recurrent discharging sinuses on the right back 4 years after laparoscopic cholecystectomy in a 44-year-old female patients. She suffered for 9 years to undergo empirical treatment for suspected tuberculosis, including repeated attempts at sinus tract excision done at different hospitals. We did a computed tomography sinogram, which revealed the tract extending from the right flank into a cavity in the right subpleural space. We proceeded with the sinus tract excision which extended between the tips of the 10th and 11th ribs, spreading to the right subpleural space where pus mixed with multiple gall stones were retrieved. Spilled stones may result in complications, making diagnosis difficult and seriously harming the patient physically, mentally, and economically. The need for accurate documentation and patient knowledge of missing gallstones cannot be understated.

Keyword

Laparoscopy; Laparoscopic cholecystectomy; Complications; Sinus tract; Gallstone