Habib Elias, Khoury Ramez, Elhadad André, Jarno Françoise, Diallo Thierno
Service de Chirurgie Viscérale et Thoracique, Hôpital Robert Ballanger, 93602 Aulnay-sous-Bois, France.
Gastroenterol Clin Biol. 2002 Oct;26(10):930-4.
A patient was admitted because of an intestinal obstruction. Eight years before, he underwent a laparoscopic cholecystectomy. Abdominal ultrasonography and small bowel series showed a gallstone in the small bowel that computed tomography scan failed to identify. Laparotomy showed a Meckel's diverticula and a biliary stone in the terminal ileum. In the literature, it has been shown that gallstone lost during laparoscopic cholecystectomy may be responsible for intraperitoneal abscess. In the contact of intestine, the stone may induce an obstructive abscess, a communicating abscess, a digestive fistula or a biliary ileus. During the postoperative course of laparoscopic cholecystectomy, these patients suffer from abdominal pain and fever lasting from few days to several months. Imaging shows the biliary gallstone mechanical complications induced by the stone. To avoid such complications, biliary gallstone that falls into the peritoneum during laparoscopic cholecystectomy should be removed under laparoscopy.
一名患者因肠梗阻入院。八年前,他接受了腹腔镜胆囊切除术。腹部超声和小肠造影显示小肠中有一颗胆结石,而计算机断层扫描未能识别。剖腹手术显示回肠末端有一个梅克尔憩室和一颗胆石。文献表明,腹腔镜胆囊切除术中丢失的胆结石可能是腹腔脓肿的原因。在与肠道接触时,结石可能引发梗阻性脓肿、交通性脓肿、消化瘘或胆石性肠梗阻。在腹腔镜胆囊切除术后的病程中,这些患者会遭受持续数天至数月的腹痛和发热。影像学检查显示结石引起的胆石机械性并发症。为避免此类并发症,腹腔镜胆囊切除术中掉入腹腔的胆石应在腹腔镜下取出。