SPILLED GALLSTONES AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A RELEVANT PROBLEM - A RETROSPECTIVE ANALYSIS OF 10,174 LAPAROSCOPIC CHOLECYSTECTOMIES

Background: Spilled gallstones after laparoscopic cholecystectomy may cause abscess formation, but the exact extent of this problem remains unclear. Method: The data (collected by the Swiss Association of Lapar oscopic and Thoracoscopic Surgery) on 10,174 patients undergoing lapar oscopic cholecystectomy at 82 surgical institutions in Switzerland bet ween January 1992 and April 1995 were retrospectively analyzed with sp ecial interest in spilled gallstones and their complications. Results: In 581 cases (5.7%) spillage of gallstones occurred; 34 of these case s were primarily converted to an open procedure for stone retrieval. O f the remaining 547 cases only eight patients (0.08%) developed postop eratively abscess formation requiring reoperation. Conclusions: Spilla ge of gallstones after laparoscopic cholecystectomy is fairly common a nd occurs in about 6% of patients. However, abscess formation with sub sequent surgical therapy remains a minor problem. Removal of spilled g allstones is therefore not recommended for all patients, but an attemp t at removal should be performed whenever possible.