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Resumen
La colecistectomía laparoscópica es el tratamiento de elección de la colelitiasis sintomática. A pesar de las múltiples ventajas reconocidas frente al abordaje laparotómico convencional, es frecuente la perforación accidental de la vesícula biliar con salida de bilis y cálculos durante la laparoscopia. Las complicaciones por cálculos intraperitoneales son poco frecuentes, aunque en ocasiones pueden conllevar consecuencias graves. Debe realizarse el máximo esfuerzo para recuperar por vía laparoscópica los cálculos vertidos a la cavidad peritoneal, reservando la conversión a laparotomía para casos seleccionados. Presentamos un caso de absceso subhepático como complicación tardía por un cálculo abandonado en la cavidad abdominal tras una colecistectomía laparoscópica.
Laparoscopic cholecystectomy is the treatment of choice in symptomatic cholelithiasis. Despite its many advantages over the conventional laparotomic approach, accidental perforation of the gallbladder with spilled stones and bile leakage is frequent during this procedure. Complications from missed gallstones are uncommon, although they can sometimes lead to severe consequences. Great effort must be made to achieve laparoscopic retrieval of all the gallstones missed into the peritoneal cavity and conversion to an open procedure should be used only in selected cases. We report a case of subhepatic abscess as a late complication of a missed gallstone during a previous laparoscopic cholecystectomy.
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