Combined Interventional Radiology and Surgical Cut-Down Approaches for Retained Gallstones

Symptomatic retained gallstones are a rare but potentially morbid condition. Post-cholecystectomy patients presenting with vague complaints or perihepatic abscesses should be considered for retained gallstones. Traditional treatment was incision and drainage or exploratory laparotomy with washout. The current standard is minimally invasive procedures. In this case report, two different and unpublished combination methods between surgery and interventional radiology were used to extract retained stones. The first patient underwent needle-wire localization pre-operatively to identify the retained stone. The surgeon cut down along the wires and excised the stone. The second patient had a 10 French drain placed to drain the abscess surrounding the stone. The surgeon cut down along the drain, as the drain’s pigtail and retained stone were located in the abscess cavity. Based on this case report, we propose using the successful method of combined interventional radiology and general surgery procedures to excise larger and deeper retained dropped gallstones.