Question:

What are the disadvantage(s) of combined percutaneous and endoscopic approach in management of dropped gallstones compare with conventional open surgery?
1. Longer hospital stay
2. Not suitable for patient with high surgical risks, such as recent myocardial infarction
3. All the stones may not be retrieved in a single operation
4. The procedure cannot be repeated via the same tract
5. All of the above





Answer:

The correct answer for the question "What are the disadvantage(s) of combined percutaneous and endoscopic approach in management of dropped gallstones compare with conventional open surgery?" is:

3. All the stones may not be retrieved in a single operation



Explanation
[However, not all the stones may be removed in a single operation. Percutaneous endoscopic stone removal can allow repeat of the procedure via the same tract. On the other hand, if open surgery was attempted, residual stones may require another more difficult re-operation. ]



From the manuscript:
Combined percutaneous and endoscopic approach in management of dropped gallstones following laparoscopic cholecystectomy
Radiology Case. 2010 Jul; 4(7):1-5


This article belongs to the Interventional section.




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From the manuscript

Combined percutaneous and endoscopic approach in management of dropped gallstones following laparoscopic cholecystectomy

Free full text article: Combined percutaneous and endoscopic approach in management of dropped gallstones following laparoscopic cholecystectomy

Abstract
Dropped gallstones due to accidental perforation of gallbladder wall during laparoscopic cholecystectomy are often encountered. However, dropped gallstones as nidus of infection with subsequent abscess formation is a rare complication of laparoscopic cholecystectomy (0.3%). Most of the reported cases of complicated dropped stones required open surgical drainage. Minimally invasive measures were less frequently employed. We report a case of dropped gallstones that were removed endoscopically through a percutaneous drainage tract.






References



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2. Mahmood SK, Tomford JW, Rosenblatt S, Gordon S. Dropped gallstones disguised as a liver abscess. Cleveland Clinic Journal of Medicine 2008; 75(4): 316-318
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3. Morrin MM, Kruskal JB, Hochman MG, Saldinger PF, Kane RA. Radiologic features of complications arising from dropped gallstones in laparoscopic cholecystectomy patients. AJR: 174, May 2000.
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4. Dasari BV, Loan W, Carey DP. Spilled gallstones mimicking peritoneal metastases. JSLS 2009 Jan-Mar;13(1):73-6.
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5. Maldjian C, Stancato-Pasik A, Shapiro RS. Abscess formation as a late complication of dropped gallstones. Abdom Imaging 1995;20:217-218.
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


6. Trerotola SO, Lillemoe KD, Malloy PC, Osterman FA. Percutaneous removal of "dropped" gallstones after laparoscopic cholecystectomy. Radiology 1993; 188:419-421.
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