Hand Andy A, Self Michael L, Dunn Ernest
Department of Surgery, Methodist Hospitals of Dallas, Dallas, Texas, USA.
JSLS. 2006 Jan-Mar;10(1):105-7.
Spillage of gallstones within the subcutaneous tissue during laparoscopic cholecystecomy may lead to considerable morbidity.
We describe an abdominal wall abscess formation in a 50-year-old female that developed 24 months after a laparoscopic cholecystectomy.
Spilled gallstones at the umbilical port site went undetected. Subsequently, an umbilical port-site abscess formed and was treated 2 years later.
Any patient with a foreign body in the subcutaneous tissues after a laparoscopic cholecystectomy should be considered to have a retained stone. Use careful dissection, copious irrigation, and a retrieval device to avoid stone spillage. If spillage does occurs, percutaneous drainage and antibiotics followed by open retrieval of the stones should achieve adequate results during those delayed presentations of abdominal wall abscesses.
腹腔镜胆囊切除术期间胆囊结石在皮下组织内溢出可能导致相当大的发病率。
我们描述了一名50岁女性腹壁脓肿的形成，该脓肿在腹腔镜胆囊切除术后24个月出现。
脐部端口处溢出的胆囊结石未被发现。随后，形成了脐部端口处脓肿，并在2年后进行了治疗。
任何腹腔镜胆囊切除术后皮下组织中有异物的患者都应被视为有结石残留。应采用仔细的解剖、大量冲洗和取石装置以避免结石溢出。如果确实发生溢出，对于那些延迟出现的腹壁脓肿，经皮引流和使用抗生素，随后开放取石应能取得满意效果。
