Severe complications of chronic cholelithiasis treatment

Am J Emerg Med. 2021 Oct:48:374.e5-374.e12. doi: 10.1016/j.ajem.2021.03.052. Epub 2021 Mar 20.

Abstract

Background: Gallstone disease is a burden affecting about 15% percent of the population around the world. The complications of gallstone disease are numerous and many require emergency care. Severe complications are not uncommon and require special attention, as lethal outcome is possible.

Case presentation: We present a retrospective analysis of eight cases describing severe complications of gallstones in patients undergoing endoscopic treatment of chronic gallstones conditions. All patients were admitted to our emergency care department following symptoms onset. The diagnostic difficulties, treatment strategies and outcomes are presented. The associated risk factors and preventative measures are discussed. Two patients developed profuse bleeding, two developed acute pancreatitis, two patients had perforation related complications. One rare case of bilioma and one case of iatrogenic injury are presented. All patients had severe condition, in two cases lethal outcome was a result of co-morbidity and difficulties in management.

Conclusion: Special care should be taken in patients with risk factors of severe complications in order to improve outcome and prevent the development of life-threatening conditions.

Keywords: Case series; Choledocholithiasis; Endoscopic treatment complications; Gallstones complications; Severe conditions.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Biliary Fistula / physiopathology
  • Biliary Fistula / therapy
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Cholecystectomy, Laparoscopic*
  • Cholelithiasis / surgery*
  • Chronic Disease
  • Common Bile Duct / injuries
  • Duodenal Diseases / physiopathology
  • Duodenal Diseases / therapy
  • Emergency Service, Hospital
  • Female
  • Gallstones / surgery
  • Gastrointestinal Hemorrhage / physiopathology
  • Gastrointestinal Hemorrhage / therapy
  • Humans
  • Iatrogenic Disease
  • Intestinal Perforation / physiopathology
  • Intestinal Perforation / therapy
  • Male
  • Middle Aged
  • Pancreatitis / physiopathology
  • Pancreatitis / therapy
  • Portal Vein
  • Postcholecystectomy Syndrome
  • Postoperative Complications / physiopathology
  • Postoperative Complications / therapy*
  • Sphincterotomy, Endoscopic*
  • Vascular Fistula / physiopathology
  • Vascular Fistula / therapy