Recurrent Gallstone-induced Intra-abdominal Abscess following Laparoscopic Drainage

Abstract

An 86-year-old man was referred to our hospital with the diagnosis of an intra-abdominal abscess. He underwent laparoscopic cholecystectomy for cholelithiasis at our hospital 2 years prior to his current presentation. Abdominal computed tomography (CT) revealed a low-density mass in the posterolateral sub-hepatic space, and we performed laparoscopic drainage of the abscess. Intraoperatively, purulent material was removed, and a single black gallstone was retrieved followed by copious irrigation of the surgical field. The patient was discharged on the 5^th postoperative day after an uneventful postoperative course. Abdominal CT performed a month after discharge revealed a recurrent abscess, which had gradually increased in size and measured 5 cm in diameter. He underwent percutaneous drainage of the abscess and was discharged 2 weeks after the procedure. No recurrence was observed 6 months after being discharged following the second procedure. Complete retrieval of lost gallstones laparoscopically is difficult and may cause recurrent intra-abdominal abscesses.