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June 1995

Gallstones Exiting the Urinary Bladder: A Complication of Laparoscopic Cholecystectomy

Arch Surg. 1995;130(6):677. doi:10.1001/archsurg.1995.01430060115026

During laparoscopic cholecystectomy (LC), the risk for dropping gallstones is not insignificant, but the resultant complication rate has been rare.1 To date, only three published reports described late discharge of dropped stones through laparoscopic tracts.2,3 We wish to report an unusual complication of dropped gallstones, causing erosion into the urinary bladder with perivesical abscess and fistula formation.

Report of Case. A 30-year-old woman with a history of bilateral ureteral reimplantation during early childhood had an LC with several stones dropped during surgery. Two and one-half years later, recurrent urinary tract infections due to Escherichia coli developed. She subsequently passed two small stones, which were composed of cholesterol and calcium bilirubinate by analysis. A cystoscopic examination revealed a fistula at the right posterior bladder wall, which drained purulent material, and one stone was discharged on probing. The patient was treated with a prolonged course of oral followed by intravenous