Läuffer J M, Krähenbühl L, Baer H U, Mettler M, Büchler M W
Department for Visceral and Transplantation Surgery, University of Bern, Inselspital, Switzerland.
Surg Laparosc Endosc. 1997 Apr;7(2):103-12.
Laparoscopic cholecystectomy has become the preferred treatment for patients with symptomatic gallstones. During this procedure, perforation of the gallbladder with spillage of stones into the peritoneal cavity is not uncommon. Finding and removing all of the spilled gallstones can be laborious and is often avoided. Left in the peritoneal cavity, however, the stones may lead to intraperitoneal abscess formation, which may require a second procedure. We report here on a patient with an intraperitoneal abscess located between the right liver lobe and the anterior abdominal wall, which contained a large gallstone (4 cm3), found 3 months after an undetected stone spillage during laparoscopic cholecystectomy. Healing was achieved after conventional laparotomy, removal of the gallstone, and surgical drainage of the abscess cavity. The review of the literature emphasizes the clinical manifestations of this rare laparoscopic complication.
腹腔镜胆囊切除术已成为有症状胆结石患者的首选治疗方法。在此手术过程中，胆囊穿孔伴结石溢入腹腔的情况并不少见。找到并清除所有溢出的胆结石可能很费力，而且常常被避免。然而，如果结石留在腹腔内，可能会导致腹腔脓肿形成，这可能需要进行二次手术。我们在此报告一名患者，其在腹腔镜胆囊切除术中未被发现结石溢出3个月后，在右肝叶和前腹壁之间发现了一个腹腔脓肿，脓肿内含有一块大的胆结石（4立方厘米）。经传统剖腹手术、取出胆结石并对脓肿腔进行手术引流后实现了愈合。文献回顾强调了这种罕见的腹腔镜并发症的临床表现。
