Cargando…

Largest case series of giant gallstones ever reported, and review of the literature

INTRODUCTION: Giant/large gallstones have high risk of complications, and technical difficulties during surgery. This case series is the largest ever reported. PRESENTATION OF CASES: Case 1: Female (44 years), with one year intermittent right upper quadrant colicky pain. Ultrasound: large gallstone...

Descripción completa

Detalles Bibliográficos
Autores principales: Al Zoubi, Mohammad, El Ansari, Walid, Al Moudaris, Ahmed A., Abdelaal, Abdelrahman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322177/
https://www.ncbi.nlm.nih.gov/pubmed/32698264
http://dx.doi.org/10.1016/j.ijscr.2020.06.001
_version_ 1783551592628224000
author Al Zoubi, Mohammad
El Ansari, Walid
Al Moudaris, Ahmed A.
Abdelaal, Abdelrahman
author_facet Al Zoubi, Mohammad
El Ansari, Walid
Al Moudaris, Ahmed A.
Abdelaal, Abdelrahman
author_sort Al Zoubi, Mohammad
collection PubMed
description INTRODUCTION: Giant/large gallstones have high risk of complications, and technical difficulties during surgery. This case series is the largest ever reported. PRESENTATION OF CASES: Case 1: Female (44 years), with one year intermittent right upper quadrant colicky pain. Ultrasound: large gallstone (normal gallbladder). Elective laparoscopic cholecystectomy (LC): 6 × 4 × 3.3 cm gallstone. Case 2: Female (41 years), presented to emergency room with 3 days right upper quadrant pain/tenderness, vomiting, and positive murphy’s sign. Ultrasound: large gallstone, calculus cholecystitis. Emergency LC: 4.5 × 3.1 × 3.5 cm gallstone. Case 3: Male (38 years), with history of gallstones and acute cholecystitis presented with intermittent right upper quadrant pain (2 months) and vomiting. Normal abdominal examination. Ultrasound: large gallstone. Elective LC: 4.1 × 4 × 3.6 cm gallstone. CONCLUSIONS: Gallstones >5 cm are very rare, with higher risk of complications. Gallbladder should be removed even if asymptomatic. Gallstones >3 cm have increased risk for gallbladder cancer, biliary enteric fistula and ileus. LC has challenges that include grasping the gallbladder wall, exposure of Calot’s triangle, and retrieval of gallbladder out of the abdomen. LC appears to be procedure of choice and should be performed by an experienced surgeon, considering the possibility of conversion to open cholecystectomy in case of inability to expose the anatomy or intraoperative difficulties.
format Online
Article
Text
id pubmed-7322177
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-73221772020-06-30 Largest case series of giant gallstones ever reported, and review of the literature Al Zoubi, Mohammad El Ansari, Walid Al Moudaris, Ahmed A. Abdelaal, Abdelrahman Int J Surg Case Rep Article INTRODUCTION: Giant/large gallstones have high risk of complications, and technical difficulties during surgery. This case series is the largest ever reported. PRESENTATION OF CASES: Case 1: Female (44 years), with one year intermittent right upper quadrant colicky pain. Ultrasound: large gallstone (normal gallbladder). Elective laparoscopic cholecystectomy (LC): 6 × 4 × 3.3 cm gallstone. Case 2: Female (41 years), presented to emergency room with 3 days right upper quadrant pain/tenderness, vomiting, and positive murphy’s sign. Ultrasound: large gallstone, calculus cholecystitis. Emergency LC: 4.5 × 3.1 × 3.5 cm gallstone. Case 3: Male (38 years), with history of gallstones and acute cholecystitis presented with intermittent right upper quadrant pain (2 months) and vomiting. Normal abdominal examination. Ultrasound: large gallstone. Elective LC: 4.1 × 4 × 3.6 cm gallstone. CONCLUSIONS: Gallstones >5 cm are very rare, with higher risk of complications. Gallbladder should be removed even if asymptomatic. Gallstones >3 cm have increased risk for gallbladder cancer, biliary enteric fistula and ileus. LC has challenges that include grasping the gallbladder wall, exposure of Calot’s triangle, and retrieval of gallbladder out of the abdomen. LC appears to be procedure of choice and should be performed by an experienced surgeon, considering the possibility of conversion to open cholecystectomy in case of inability to expose the anatomy or intraoperative difficulties. Elsevier 2020-06-11 /pmc/articles/PMC7322177/ /pubmed/32698264 http://dx.doi.org/10.1016/j.ijscr.2020.06.001 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Al Zoubi, Mohammad
El Ansari, Walid
Al Moudaris, Ahmed A.
Abdelaal, Abdelrahman
Largest case series of giant gallstones ever reported, and review of the literature
title Largest case series of giant gallstones ever reported, and review of the literature
title_full Largest case series of giant gallstones ever reported, and review of the literature
title_fullStr Largest case series of giant gallstones ever reported, and review of the literature
title_full_unstemmed Largest case series of giant gallstones ever reported, and review of the literature
title_short Largest case series of giant gallstones ever reported, and review of the literature
title_sort largest case series of giant gallstones ever reported, and review of the literature
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322177/
https://www.ncbi.nlm.nih.gov/pubmed/32698264
http://dx.doi.org/10.1016/j.ijscr.2020.06.001
work_keys_str_mv AT alzoubimohammad largestcaseseriesofgiantgallstoneseverreportedandreviewoftheliterature
AT elansariwalid largestcaseseriesofgiantgallstoneseverreportedandreviewoftheliterature
AT almoudarisahmeda largestcaseseriesofgiantgallstoneseverreportedandreviewoftheliterature
AT abdelaalabdelrahman largestcaseseriesofgiantgallstoneseverreportedandreviewoftheliterature