To the Editor.—With the explosion of the use of laparoscopy in the performance of cholecystectomy, increasing numbers of gallstones are being left in the peritoneal cavity. During an open procedure, perforation of the gallbladder with spillage is less common. Further, any spilled stones and debris can be removed easily. To our knowledge, there have been no reports of serious sequelae related to stones left free in the peritoneal cavity. However, we have observed adhesions in a patient who had undergone laparoscopic cholecystectomy with stone spillage 4 months earlier. During a subsequent open operation for Crohn's disease, these stones were discovered encapsulated by filmy adhesions and attached to the colon and liver.
To examine the issue further, preweighed sterile human gallstones measuring 5 to 7 mm in diameter were implanted freely into the abdomens of 12 male Sprague-Dawley rats. The animals were harvested at 1,2, and 4 months. There was