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Largest case series of giant gallstones ever reported, and review of the literature
Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar. (Individ och samhälle VIDSOC, Individual and Society)ORCID iD: 0000-0003-0961-1302
Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
2020 (English)In: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 72, p. 454-459Article in journal (Refereed) Published
Abstract [en]

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. © 2020 The Author(s)

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 72, p. 454-459
Keywords [en]
Giant gallstone, Laparoscopic cholecystectomy, Large gallstone, Open cholecystectomy, acute cholecystitis, adult, Article, case report, cholangiography, cholecystitis, chronic cholecystitis, clinical article, colic, common bile duct stone, echography, elective surgery, emergency care, female, follow up, gallstone, histopathology, human, intestine metaplasia, male, priority journal, upper abdominal pain, vomiting
National Category
Surgery Gastroenterology and Hepatology
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-18904DOI: 10.1016/j.ijscr.2020.06.001ISI: 000548926300025PubMedID: 32698264Scopus ID: 2-s2.0-85086677569OAI: oai:DiVA.org:his-18904DiVA, id: diva2:1457727
Note

Correspondence Address: El Ansari, W.; Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Qatar; email: welansari9@gmail.com

Available from: 2020-08-12 Created: 2020-08-12 Last updated: 2024-01-17Bibliographically approved

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