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Author Notes:

Nariman Nezami Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street N2E23, Baltimore, MD 21201, USA E-mail: dr.nezami@gmail.com

Conceptualization: NN; Data curation: JS; Investigation: NN, DRE, WRG, JS; Project administration: NN; Supervision: NN; Writing–original draft: KB; Writing–review & editing: NN, DRE, WRG, BSM, JS.

The authors would like to thank Dr. Janice M. Newsome for her help.

Nariman Nezami is consultant with RenovoRx and CAPS Medical. The other authors have no potential conflicts of interest.



  • post-cholecystectomy

Percutaneous endoscopy (peritoneoscopy) and lithotripsy for retrieval of dropped gallstones post-cholecystectomy


Journal Title:

Clinical Endoscopy


Volume 55, Number 6


, Pages 819-823

Type of Work:

Article | Final Publisher PDF


The most common complication of laparoscopic cholecystectomy is iatrogenic perforation of the gallbladder, with gallstone spillage into the abdominal cavity. Also known as “dropped gallstones”, this complication occurs in up to 30% of patients, but is clinically silent in the majority of cases.1 If symptoms arise, they are generally related to the complications of dropped gallstones such as abscess and fistulae formation, which often lead to significant morbidity.2,3 The most common location for abscess formation secondary to dropped gallstones is the subhepatic space, more specifically known as Morrison’s pouch.4 The time from spillage of gallstones to abscess formation ranges from 5 days up to 5 years.4,5 Development of inflammatory masses resembling tumors, abdominal wall abscesses, and pleural empyema have also been reported as alternative presentations.1,5 Diagnosis of dropped gallstones is a challenge since majority of gallstones are radio-lucent on computed tomography (CT) and they have the propensity to migrate to different locations.2 Definitive treatment of dropped gallstones is often limited to laparotomy, since laparoscopic retrieval could be technically challenging. Both approaches expose patients to additional morbidity if they are surgical candidates.6

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
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