Limy bile and laparoscopic cholecystectomy

Objective to determine incidence of 'limy bile' in patients undergoing lapa roscopic cholecystectomy; to analyze patient characteristics and preoperati ve imaging modalities in these patients and evaluate surgical treatment Patients and Methods : a retrospective analysis of 1800 laparoscopic cholec ystectomies performed between March 1990 and March 1998 for symptomatic gal lbladder disease. Results : Five patients with limy bile (0,27%) were identified. Four were f emale and one was male, age varied from 42 to 66. Most patients were sympto matic longtime before presentation. Ultrasound was not able to differentiat e between normal gallstones or sludge. In three patients the diagnosis was made before operation, in one patient it was an incidental finding. Surgery in these patients is not more difficult than in any other patient. Conclusion : Limy bile is a rare finding (0,27% in 1800 cholecystectomies). Plain abdominal X-rays mostly suggest the presence of calcium carbonate pr ecipitate in the gallbladder, but ultrasound cannot differentiate between c holelithiasis and limy bile. Laparoscopic resection can be performed withou t problems in most patients. Preoperative diagnosis of this rare entity is not essential, as it does not alter treatment.