Cases reported "Cholelithiasis"

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1/108. Peritoneal abscess formation as a late complication of gallstones spilled during laparoscopic cholecystectomy.

    The case is described of a 74-year-old woman who presented with an abdominal abscess 1.5 years after laparascopic cholecystectomy. CT and ultrasound showed the presence of gallstones within the abscess. Spillage of gallstones from perforation of the gallbladder is a well recognized complication of laparascopic cholecystectomy, although subsequent abscess formation is unusual especially after a long delay as in this case.
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ranking = 1
keywords = abdominal abscess, abscess
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2/108. Port-site metastasis after laparoscopic cholecystectomy for benign disease.

    We describe the case history of a patient presenting with a port-site metastasis from an occult pancreatic malignancy after laparoscopy for benign gallbladder disease. While port-site recurrence is well recognized after laparoscopy for malignant disease, its presentation after laparoscopy for benign disease is rare, this being only the third such case to be reported in the literature. It emphasizes that all pathology localizing to port sites after surgery should be investigated, as it may represent the earliest sign of a hitherto occult intra-abdominal malignancy.
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ranking = 0.00089330826448222
keywords = intra-abdominal
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3/108. Cholelithoptysis and pleural empyema.

    We report a case of delayed cholelithoptysis and pleural empyema caused by gallstone spillage at the time of laparoscopic cholecystecomy. An occult subphrenic abscess developed, and the patient became symptomatic only after trans-diaphragmatic penetration occurred. This resulted in expectoration of bile, gallstones, and pus. Spontaneous decompression of the empyema occurred because of a peritoneo-pleuro-bronchial fistula. This is the first case of such managed nonoperatively and provides support for the importance of intraoperative retrieval of spilled gallstones at the time of laparoscopic cholecystectomy.
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ranking = 0.0072331822319226
keywords = abscess
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4/108. Percutaneous papillary balloon dilatation as a therapeutic option for cholecystocholedocholithiasis in the era of laparoscopic cholecystectomy.

    The present study was conducted to evaluate the effectiveness of percutaneous papillary balloon dilatation (PPBD) as a therapeutic option for cholecystocholedocholithiasis, in combination with laparoscopic cholecystectomy (LC). A total of 15 patients with both bile duct and gallbladder stones were clinically investigated. In 14 patients, PPBD was performed 2 to 7 days prior to LC, while in the remaining patient, PPBD was performed immediately after LC under general anesthesia in one continuous session. The bile duct stones were successfully pushed out into the duodenum in all the patients, seven of whom required two sessions for complete stone clearance, while the other eight needed only one session. Two patients had bile duct stones larger than 12 mm in diameter, necessitating electrohydraulic lithotripsy under cholangioscopy. The insertion of a percutaneous transhepatic biliary drainage tube did not cause intra-abdominal adhesions severe enough to contraindicate the use of LC. The operation times for LC varied from 80 to 184 min, with a mean operation time of 132 min, and the average postoperative and overall hospital stays were 9 and 26 days, respectively. There were no deaths or major complications, apart from transient hyperamylasemia. The findings of this study indicate that PPBD combined with LC is a safe and effective therapeutic option for cholecystocholedocholithiasis.
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ranking = 0.00089330826448222
keywords = intra-abdominal
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5/108. A case of complex hepatolithiasis successfully treated with a systematic approach.

    A systematic approach is required to treat complex hepatolithiasis. A 45 year-old female patient with hepatolithiasis had bilateral intrahepatic stones, biliary strictures at the right hepatic duct and segment IV duct, cholangitic abscess, and shrinkage of the right hepatic lobe. Six sessions of lithotomy were carried out under the guidance of percutaneous transhepatic choledochoscopy using a dye-laser lithotriptor through the segment III duct. Although stones were eradicated from the common bile duct and segment III duct, stones remained in other segments where cholangioscopic access was not feasible. Biliary bilirubin concentration increased and the liver abscess was resolved. Thereafter, the patient underwent right hepatectomy and choledochojejunostomy. After surgery, percutaneous transhepatic cholangio-drainage and balloon dilatation of the segment IV duct was performed. The patient underwent 11 more sessions of cholangioscopic lithotomy through 2 transhepatic routes and the bilioenteric bypass. Thereafter, the patient became almost stone-free. After discharge, biliary tracts were irrigated with saline through a subcutaneously placed reservoir. The patient is alive and well and had been without stone recurrence for 3 years. This report shows the efficacy of the vigorous combination therapy, including repeated cholangioscopic lithotomy through multiple routes using laser lithotripsy, surgery, and long-term biliary irrigation.
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ranking = 0.014466364463845
keywords = abscess
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6/108. Transdiaphragmatic abscess: late thoracic complication of laparoscopic cholecystectomy.

    Spillage of gallstones into the peritoneal cavity is a frequent problem during laparoscopic cholecystectomy (as much as 30%) and is frequently dismissed as a benign occurrence. However, several complications associated with spillage of gallstones have been reported recently. Most of these complications presented late after the original procedure, many with clinical pictures not related to biliary etiology, confounding and delaying adequate management. For patients presenting with intraabdominal or thoracic abscesses of unknown etiology, if there is a history of laparoscopic cholecystectomy, regardless of the time interval, certain evaluations should be considered. A sonogram and a CT scan are advisable to detect retained extraluminal gallstones, as most patients will require, not only drainage of fluid collections, but also removal of the stones. A case is described of a patient who presented with a right empyema and transdiaphragmatic abscess 18 months after a laparoscopic cholecystectomy. Treatment included decortication, enbloc resection of the abscess, repair of the diaphragm, and drainage.
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ranking = 0.050632275623458
keywords = abscess
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7/108. Complications of "dropped" gallstones after laparoscopic cholecystectomy: technical considerations and imaging findings.

    New laparoscopic techniques have revolutionized the practice of surgery. Laparoscopic cholecystectomy has become one of the most commonly performed surgeries worldwide. Although shorter hospital stays and patient comfort have offered clear advantages over open cholecystectomy, the technique has resulted in several specific complications, including bile duct injury and gallbladder perforation. Although rarely clinically significant, intraperitoneal gallstone spillage can cause abscess formation and adhesions. Although these patients can present with a confusing clinical picture, their characteristic radiologic features should be recognized. We present two cases of complicated intraperitoneal gallstone spillage radiologically diagnosed and treated with laparoscopic and interventional radiologic techniques.
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ranking = 0.0072331822319226
keywords = abscess
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8/108. Retroperitoneal abscess after retained stones during laparoscopic cholecystectomy.

    Laparoscopic cholecystectomy is associated with a significant risk of gallbladder perforations with bile and stone spillage. The retrieval of dropped stones is sometimes impossible, and intraperitoneally retained stones can be the source of serious complications, such as inflammatory masses or abscesses. The authors describe a patient in whom a large retroperitoneal abscess developed as a result of missed stone fragments during cholecystectomy. Although several cases of intraperitoneal abscess have been reported in the literature, retroperitoneal collection is very uncommon. Crushed and infected stones seem to be the essential prerequisite for abscess formation. Therefore, every attempt should be made to avoid stone spillage and intra-abdominally retained stones. conversion to open surgery has to be considered in the presence of adverse factors, such as primary acute cholecystitis or cholecystitis induced by previous sphincterotomy, or bilirubinate stones believed to be infected. abdominal abscess treatment requires removal of missed stones by surgical incision or new laparoscopic procedure because simple percutaneous drainage is usually unsuccessful.
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ranking = 0.065991948351786
keywords = abscess, intra-abdominal
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9/108. Late complication following percutaneous cholecystostomy: retained abdominal wall gallstone.

    A case of recurrent abdominal wall abscess following percutaneous cholecystostomy (PC) is presented. Transperitoneal PC was performed in an 82-year-old female with calculous cholecystitis. Symptoms resolved and the catheter was removed 29 days later. The patient came back 5 months later with a superficial abscess that was drained and 8 months post PC with a fistula discharging clear fluid. ultrasonography revealed the tract adjacent to an area of inflammation containing a calculus, whereas CT failed to depict the stone. Subsequent surgery confirmed US findings. To our knowledge, this is the first report of a dislodged bile stone following percutaneous cholecystostomy.
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ranking = 0.014466364463845
keywords = abscess
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10/108. Biliary hamartomas associated with biliary stones presenting as multiple microabscesses: case report.

    A 63-year-old men suffered from fever, jaundice, and right upper quadrant pain for 1 week. Biliary stones with biliary tract infection were diagnosed. He was treated with parenteral antibiotics. However, abdominal ultrasonography showed multiple hyperechoic lesions in both lobes, and infiltrating hepatocellular carcinoma was suspected initially. Numerous hypervascular nodular-enhancing lesions were revealed by computed tomography. magnetic resonance imaging further disclosed numerous tiny cystic lesions with peripheral enhancement. Exploratory laparotomy was performed for biliary calculi and probable underlying malignancy. cholecystectomy, choledocholithotomy, and liver wedge biopsy were done. The pathology revealed bile duct hamartomas with microabscess formation. The past literature about biliary hamartomas is reviewed.
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ranking = 0.036165911159613
keywords = abscess
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