Cengizhan YİĞİTLER, Kazım DUMAN, Ali ÖZCAN

Giant gallstone in abdominal wall: a rare complication of laparoscopic cholecystectomy

Laparoskopik kolesistektomi postoperatif komplikasyonları oldukça çeşitlidir. Bu vakada amacımız, perfore safra kesesinin ekstrakte edilirken, dökülen safra taşının batın ön duvarında kalması ve burada kitle formasyonu göstermesinin sunulmasıdır. 73 yaşında bayan bir hastanın, Laparoskopik kolesistektomi ameliyatından yaklaşık 1 yıl sonra port yerinden pürülan akıntı, şişlik şikâyetleriyle müracaat etmesi sonucu hastaya yapılan Batın tomografisi ve ultrasonografisinde; cilt altında rektus kası önünde taş ekojenitesinin gözlenmiştir. Hasta operasyona alınmış ve taş ekstrakte edilmiştir. Sonuç olarak; Laparoskopik kolesistektomi olguları uzun dönem takip edilmeli, safra kesesi karaciğer yatağından son derece nazik diseke edilmeli, batın dışına alınırken endoskopik torba kullanılmalıdır.

Anahtar Kelimeler:

Abdominal duvar; laparoskopik kolesistektomi; safra taşı.

Batın ön duvarında dev safra taşı; nadir laparoskopik kolesistektomi komplikasyonu

We aim to report a case of abdominal wall mass formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy (LC). A 73-year-old women presented with purulent discharge from one of her previous port sites one year after she underwent LC. The latter revealed a round opaque mass in an abscess like cavity, and subsequently an ultrasonography showed a round echogenity with acoustic shadow posteriorly. Axial CT images verified the presence of a well-circumscribed hyperdensity which was really a gallstone in a cystic mass. To reduce this complication, excessive traction of the gallbladder should be avoided during dissection. Prior to extraction, gallbladder contents should be aspirated, and to extract larger stones. In the event of perforation occurring, the gallbladder should be placed in a plastic bag, spilled stones should be retrieved where possible and excessive irrigation used to remove the bile.

Keywords:

Abdominal wall; gallstones; laparoscopic cholecystectomy.,

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