Clip migration causes choledocholithiasis after laparoscopic cholecystectomy.

T. Yoshizumi, Tetsuo Ikeda, T. Shimizu, S. Ohta, S. Nagata, T. Sonoda, K. Sugimachi

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The migration of surgical clips after laparoscopic procedures was first reported in 1992, but such instances are extremely rare. We herein demonstrate a case of a migrated metal clip, which had been applied originally to the cystic duct, but thereafter had moved to the common bile duct. This clip caused choledocholithiasis in a patient 1 year after a laparoscopic cholecystectomy. A 63-year-old man underwent a laparoscopic cholecystectomy. During the operation, the inflamed cystic duct was divided accidentally, and three clips were applied immediately. The patient complained of upper abdominal pain from postoperative day 8. Endoscopic retrograde cholangiography demonstrated bile leakage from the cystic duct, but showed no clips or choledochal stones. The patient complained of severe upper abdominal and back pain 1 year after the operation. Endoscopic retrograde cholangiography showed a metal clip in the common bile duct and choledochal stones above the clip. The clip and the cholesterol stones were removed using a basket catheter. Three clips applied to the cystic duct should have been removed because of the necrosis in the remaining cystic duct. Thereafter, the clip may have migrated through the stump of the cystic duct into the lower part of the common bile duct. This clip seems to have later caused choledocholithiasis resulting from stagnation of the bile flow. Bile leakage after an operation seems to increase the risk of clip migration. Regardless of the primary lesion, a careful follow-up evaluation is necessary for patients demonstrating complications.

Original languageEnglish
Number of pages1
JournalSurgical endoscopy
Volume14
Issue number12
Publication statusPublished - Jan 1 2000

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Choledocholithiasis
Laparoscopic Cholecystectomy
Surgical Instruments
Cystic Duct
Common Bile Duct
Bile
Cholangiography
Abdominal Pain
Metals
Back Pain
Necrosis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Yoshizumi, T., Ikeda, T., Shimizu, T., Ohta, S., Nagata, S., Sonoda, T., & Sugimachi, K. (2000). Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. Surgical endoscopy, 14(12).

Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. / Yoshizumi, T.; Ikeda, Tetsuo; Shimizu, T.; Ohta, S.; Nagata, S.; Sonoda, T.; Sugimachi, K.

In: Surgical endoscopy, Vol. 14, No. 12, 01.01.2000.

Research output: Contribution to journalArticle

Yoshizumi, T, Ikeda, T, Shimizu, T, Ohta, S, Nagata, S, Sonoda, T & Sugimachi, K 2000, 'Clip migration causes choledocholithiasis after laparoscopic cholecystectomy.', Surgical endoscopy, vol. 14, no. 12.
Yoshizumi T, Ikeda T, Shimizu T, Ohta S, Nagata S, Sonoda T et al. Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. Surgical endoscopy. 2000 Jan 1;14(12).
Yoshizumi, T. ; Ikeda, Tetsuo ; Shimizu, T. ; Ohta, S. ; Nagata, S. ; Sonoda, T. ; Sugimachi, K. / Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. In: Surgical endoscopy. 2000 ; Vol. 14, No. 12.
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