Intraperitoneal Gallstones Dropped or Spilled Stones

The Gallstone Elimination Report

Gallstone Natural Solutions by David Smith

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With the advent of LC, spillage of gallstones into the peritoneal cavity due to perforation of the gallbladder or spillage during removal of the gallbladder itself has become a recognized complication of cholecys-

tectomy, one rarely seen with open cholecystectomy. Initial opinion was that stones left in the peritoneal cavity were harmless. However it is now accepted that there are potential complications from dropped stones, including abscess, sinus tracts, septicemia, and adhesions. Improvements in instrumentation, improved video systems, and modifications in technique have been developed which have helped to prevent stone spillage. When spillage is noted to occur, attempts to retrieve dropped stones should be made [46]. In selected cases, open retrieval should be considered if a large number of stones or large stones have been spilled. Stones or stone fragments can lodge in any site in the peritoneal cavity and may even migrate into the pleural space and pulmonary parenchyma, resulting in empyema or lithopty-sis [47,48]. Stones may also be trapped in trocar sites. The incidence of dropped stones has been reported to range from 6 to 16% [46,49]. It is believed that less than 1% of these patients will develop an abscess or other complication requiring reoperation, although the true incidence is unknown because of delayed presentation. The average time from surgery to presentation due to a complication from a dropped stone is 27.3 weeks [50].

The development of abscesses from dropped stones is probably related to the significant bacterial content gallstones [51]. It has been shown that bacteria also have an adhesive property that facilitates pigment stone formation [52]. This correlates with the finding that most abscesses due to dropped stones are found in association with calcified stones. Another explanation may be that infected bile causes these abscesses.

The diagnosis is often made by CT imaging. A calcified nidus is often identified within the abscess (Figs. 4.28-4.30). If the stone is not calcified, the etiology of the abscess may be initially unclear.

Figure 4.28. "Dropped stone" after cholecystectomy. Coned-down view of the pelvis reveals a calcific density due to a dropped stone postcholecystectomy. (Courtesy of R. Wachsberg, M. D., Newark, NJ)

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Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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