The lost gallstone

Laparoscopic cholecystectomy has become the treatment of choice for most patients with gallstones. During this procedure it is not uncommon for the gallbladder to be entered inadvertently, spilling gallstones freely into the peritoneal cavity. Finding and removing all of the spilled gallstones can be difficult and time consuming. The natural history of stones left in the peritoneal cavity, outside the gallbladder, bile ducts, or intestine, is not known.This is a case report of a complication related to several gallstones left in the peritoneal cavity after laparoscopic cholecystectomy. An abscess developed around them, which necessitated the drainage of purulent exudate from the right flank 8 months postoperatively. The abscess and sinus tract did not heal until the stones were removed. If possible, all stones should be removed during laparoscopic cholecystectomy to forestall the development of this type of complication.