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Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1782
De Pasquale L., Gobbi G., Vitri P., De Nicola E., Ceriani F., Bastagli A.
Background. Gallbladder perforation during laparoscopic cholecystectomy, with bile and stones spillage into the peritoneal cavity is not uncommon. Left into the abdomen the stones may lead to intraperitoneal abscess formation or to other complications. However this happens in only few cases. The purpose of this paper is to define the indications for conversion to an open procedure when stones spillage occurs.
Methods. From 1990 to 1997, 535 VLC were performed; 59 gallbladder perforations occurred. Out of these, stones spillage was observed in 21 patients. In only one case the patient needed a new procedure for abdominal abscess two years later.
Results. The incidence of complications after gallbladder perforation and stones spillage has been 1.7%. The only patient who required a new procedure for abdominal abscess, was operated on for acute cholecystitis.
Conclusions. When gallbladder perforation occurs, stones spillage in abdominal cavity should be avoided. However if this happens, the conversion to laparotomy is necessary only in patients with acute cholecystitis and little multiple stones. In all other cases the simple irrigation of peritoneal cavity is sufficient.