Keywords :
Case report, Giant gallstones, Laparoscopic cholecystectomy, Large gallstones, Open cholecystectomy
Citation Information :
Rehman S, Sharma D, Dubey N, Vyas KC. A Case Series of Laparoscopic Cholecystectomy for Giant Gallbladder Stones. World J Lap Surg 2025; 18 (1):38-41.
Gallbladder (GB) stones are a very common scenario in surgical cases operated worldwide. However, large GB stones are rarely reported and operated on due to the fact of high risk of complications and technical difficulties during surgery with few successful outcomes or postoperative complications.
Here we report a case series of successful laparoscopic cholecystectomies done for large GB stones, the largest measuring 7 × 6 cm with no complications and positive outcomes with no mortality or postoperative complications in the Indian and Asian subcontinent.
Case presentation:Case 1: A 77-year-old female with complaints of right hypochondriac pain. Ultrasound report suggestive of contracted GB filled with echogenic shadow. Elective laparoscopic cholecystectomy was performed with the removal of 7 × 6 cm large solitary GB stone through an extended umbilical port.
Case 2: A 45-year-old female presented in emergency with a complain of colicky pain in her abdomen. Radiological findings are suggestive of a large GB stone measuring 6 × 5 cm. Laparoscopic cholecystectomy was performed safely.
Case 3: A 51-year-old male presented with a history of cholelithiasis and cholecystitis with pain and vomiting. Ultrasound findings reveal multiple large gall stones largest measuring 4 × 3 cm and smallest 1.5 × 1 cm with a total 5 GB stones operated laparoscopically.
Case 4: A 40-year-old female with history of acute cholecystitis with intermittent right upper quadrant pain and vomiting. Ultrasound suggestive of large GB stone of size measuring 5 × 4 cm.
Conclusions: Large gallstones >5 cm are rare, with a greater incidence of complications during surgical and postoperative management. It is advocated to operate even in asymptomatic cases as they have higher risks of GB cancer, biliary enteric fistula, and ileus. Laparoscopic management poses risks and challenges including grasping GB wall, calots triangle exposure, and extraction of large stones from 10 mm size ports. In cases of large GB stones, there are likelihood of conversion from laparoscopic to open cholecystectomy. However laparoscopic management is the gold standard procedure in the hands of experienced surgeons and is the procedure of choice as a laparoscopic approach has higher benefits than the traditional open method.
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