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This case series is the largest ever reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of cases<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Case 1<\/jats:bold>\n                      : Female (44 years), with one year intermittent right upper quadrant colicky pain. Ultrasound: large gallstone (normal gallbladder). Elective laparoscopic cholecystectomy (LC): 6 \u00d7 4 \u00d7 3.3 cm gallstone.\n                      <jats:bold>Case 2<\/jats:bold>\n                      : Female (41 years), presented to emergency room with 3 days right upper quadrant pain\/tenderness, vomiting, and positive murphy\u2019s sign. Ultrasound: large gallstone, calculus cholecystitis. Emergency LC: 4.5 \u00d7 3.1 \u00d7 3.5 cm gallstone.\n                      <jats:bold>Case 3<\/jats:bold>\n                      : Male (38 years), with history of gallstones and acute cholecystitis presented with intermittent right upper quadrant pain (2 months) and vomiting. Normal abdominal examination. Ultrasound: large gallstone. Elective LC: 4.1 \u00d7 4 \u00d7 3.6 cm gallstone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gallstones &gt;5 cm are very rare, with higher risk of complications. Gallbladder should be removed even if asymptomatic. Gallstones &gt;3 cm have increased risk for gallbladder cancer, biliary enteric fistula and ileus. LC has challenges that include grasping the gallbladder wall, exposure of Calot\u2019s triangle, and retrieval of gallbladder out of the abdomen. LC appears to be procedure of choice and should be performed by an experienced surgeon, considering the possibility of conversion to open cholecystectomy in case of inability to expose the anatomy or intraoperative difficulties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.06.001","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T12:51:41Z","timestamp":1591879901000},"page":"454-459","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Largest case series of giant gallstones ever reported, and review of the literature"],"prefix":"10.1097","volume":"72","author":[{"given":"Mohammad","family":"Al Zoubi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"El Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Al Moudaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Abdelaal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-100-20260114","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1148\/radiographics.20.3.g00ma16751","article-title":"Gallbladder stones: imaging and intervention","volume":"20","author":"Bortoff","year":"2000","journal-title":"RadioGraphics"},{"key":"R2-100-20260114","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5009\/gnl.2012.6.2.172","article-title":"Epidemiology of gallbladder disease: cholelithiasis and cancer","volume":"6","author":"Stinton","year":"2012","journal-title":"Gut Liver"},{"key":"R3-100-20260114","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1007\/s11605-016-3096-0","article-title":"The progression of cholelithiasis to gallstone ileus: do large gallstones warrant surgery?","volume":"20","author":"Freeman","year":"2016","journal-title":"J. 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