From Dormant Debris to Danger: Unveiling Spilled Gallstones Intriguing Transformation into Preperitoneal Abscess

Background: Laparoscopic cholecystectomy is one of the most commonly performed surgery worldwide. Gall Stone spillage during surgery can occur either due to perforation of the gall bladder or during Gall bladder extraction from the port. We are presenting a case of unusual port site complication following laparoscopic cholecystectomy.

Case Summary: A 42-year-old gentleman, presented with complaints of swelling in the upper abdomen for 6 months, not associated with any other symptoms. Past h/o Cholecystectomy 5 years back. O/E Previous laparoscopic port site scar completely healed well, palpable cystic intra abdominal mass above the umbilicus, freely mobile in all directions which was non-tender. On further evaluation with an Ultrasound and Contrast-enhanced Computed Tomography scan (CECT) of the abdomen diagnosed as intra-peritoneal cyst. The decision was made to proceed with Laparoscopic excision. Intra operatively, the cyst was arising from the preperitoneal space of the anterior abdominal wall, containing pus and retained Gall stone.

Conclusion: Most of the patients with retained gallstones remains asymptomatic, they can present at any time with variable symptoms. This can be prevented by avoiding Gall bladder perforation and the use of an endo bag for gall bladder retrieval from the port.