Spontaneous Erosion of a Lost Intra-Abdominal Gallstone Through the Back Eight Months Following Laparoscopic Cholecystectomy

BACKGROUND AND OBJECTIVES Gallbladder perforation during laparoscopic cholecystectomy with spillage of bile and gallstones occurs in up to 40% of patients. Several reports have recently been published describing complications related to these lost gallstones. The purpose of this study was to determine the incidence of this complication in our patients. METHODS A prospectively maintained database of 856 laparoscopic cholecystectomies performed between 1989 and 1996 by a single surgeon was analyzed. RESULTS The number of perforations resulting in loss of stones in the abdominal cavity was 16% (165 patients). Of these 165 patients, only a single patient could be identified as having a long-term complication. CONCLUSIONS Intra-abdominal lost gallstones can produce complications secondary to migration and erosion. It is prudent to make a concerted effort to remove spilled gallstones by every possible means but conversion to laparotomy is not justifiable.