Al-Janabi Moatasem Hussein, Aslan Raghad Ghaleb, Hasan Alissar Mehsen, Doarah Marah, Daoud Raghad, Wassouf Ali, Houreih Mohammad Adib
Department of Pathology, Cancer Research Center, Tishreen University Hospital, Lattakia, Syria.
Tishreen University Faculty of Medicine, Lattakia, Syria.
Ann Med Surg (Lond). 2022 Sep 5;81:104557. doi: 10.1016/j.amsu.2022.104557. eCollection 2022 Sep.
Dropped gallstones are an uncommon complication of laparoscopic cholecystectomy. Few reports have described dropped gallstones that were found accidently. Here, we encountered two cases of dropped gallstones that were unexpectedly found during surgery.
Case 1 involved a 54-year-old woman who has undergone a total abdominal hysterectomy with bilateral salpingo-oophorectomy for endometrioid cancer in the right ovary which was confirmed by histology. During surgery, a small firm nodule was seen in the omentum. An omentectomy is done for histological evaluation. Case 2 involved a 29-year-old woman admitted for an elective Caesarean section. During surgery, a firm nodule in the vesicouterine pouch was found. The nodule was carefully removed and sent to the pathology department. Microscopically, both cases revealed a fibrous wall enclosing gallstone associated with a foreign body-type granulomatous reaction.
Dropped gallstones (DGs), also referred to as spilled gallstones, into the peritoneal cavity are an uncommon complication of laparoscopic cholecystectomy. Clinically spilled gallstones usually remain silent for months or years after laparoscopic cholecystectomy and can be found during imaging or surgery.
Clinicians should keep in mind that mass-forming lesions within the peritoneal cavity, due to dropped gallstones, may mimic neoplasia.
胆囊结石脱落是腹腔镜胆囊切除术一种罕见的并发症。很少有报告描述意外发现的脱落胆囊结石。在此，我们遇到两例在手术中意外发现的脱落胆囊结石病例。
病例1为一名54岁女性，因右侧卵巢子宫内膜样癌接受了全腹子宫切除术及双侧输卵管卵巢切除术，组织学检查确诊。手术过程中，在大网膜上发现一个小而硬的结节。进行了大网膜切除术以进行组织学评估。病例2为一名29岁女性，因择期剖宫产入院。手术过程中，在膀胱子宫陷凹发现一个硬结节。小心切除该结节并送至病理科。显微镜检查显示，两例均可见一个纤维壁包裹着胆囊结石，并伴有异物型肉芽肿反应。
胆囊结石脱入腹腔（DG），也称为溢出性胆囊结石，是腹腔镜胆囊切除术一种罕见的并发症。临床上，溢出性胆囊结石在腹腔镜胆囊切除术后通常数月或数年无症状，可在影像学检查或手术中发现。
临床医生应牢记，腹腔内由脱落胆囊结石形成的肿块性病变可能酷似肿瘤。
