Giant gall stone: a rare finding performed with open cholecystectomy

Abstract

Very few cases of a giant gall stone (>50mm) are reported worldwide. Author reported a case of a gall stone measuring 80x44x41mm in a 64 years old female who underwent open cholecystectomy at our institution. Gall stones measuring more than 30mm are associated with a higher risk of developing gall bladder carcinoma and any patient who is harbouring a large calculus requires cholecystectomy. Large gall stones when detected on abdominal sonography throw a reasonable surgical challenge as on usual basis, laparoscopic cholecystectomy is an ideal approach for intervention in cholelithiasis. Giant gall stones are also associated with a wide spectrum of diseases including Bouveret syndrome, colonic ileus etc. Once a surgery is planned for a giant gall stone, open procedure is better than laparoscopic cholecystectomy as the latter is difficult to perform owing to the large size of calculus and associated adhesions in the region of Calot’s triangle. It further saves the patient from unnecessary conversion to open procedure that may occur subsequently in due course of surgery that involves a giant calculus.