A tale of three spilled gall stones: one liver mass and two abscesses

Abstract

Spilled gall stone has been one of the most common complications of laparoscopic cholecystectomy. Spillage occurs in up to 40% of cases; complications related to spillage are rare and can present within weeks to years. We report 3 cases referred to a tertiary centre for management of such complications. The first patient presented with clinical and radiological findings of cyst 1 week after laparoscopic cholecystectomy. She was initially thought to have a hydatid cyst. At laparotomy it turned out to be a liver abscess with stones at the centre of the cavity. The second patient presented with recurrent episodes of fever and on investigation was found to have a sub-hepatic abscess. The third patient had similar clinical symptoms to the second patient but presented 7 years after surgery. We recommend that every attempt should be made to avoid gall-bladder perforation during dissection; if this happens every effort should be made to remove the spilled stones.