Sometimes one or more gallstones are lost during a laparoscopic cholecystectomy, usually through a tear in the gallbladder wall. These may be innocuous but sometimes they cause complications and need to be removed.
Stones lost within peritoneal cavity may be associated with:
(1) no reaction
(2) fibrosis and/or adhesions
(3) abscess
(4) fistula
Occasionally lost stones may migrate:
(1) into the urinary tract
(2) into the pleural cavity
(3) into the lungs, with cholelithoptysis
Other complications:
(1) small bowel obstruction
(2) sepsis
Risk factors for complications (Brockmann et al):
(1) older age
(2) male gender
(3) acute cholecystitis
(4) pigment stones
(5) > 15 stones
(6) large stone (> 1.5 cm in diameter)
(7) perihepatic localization
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