Cholecystolithiasis develops easily in the bile duct and can develop due to the presence of a foreign substance, such as artificial silk, inside the bile duct [1]. Most of such incidents have been reported as case reports. adhérons aux principes de la charte HONcode. 2. We present herein the case of a woman who developed unexpected complications following a laparoscopic cholecystectomy. Bienvenue sur EM-consulte, la référence des professionnels de santé. tion3 post-laparoscopic cholecystectomy, as well as migra-tion to more remote and dependent organs like ovary and causing symptoms.4 References 1. 2010;14(4):688–96. may email you for journal alerts and information, but is committed Postcholecystectomy clip migration is rare and can lead to complications such as clip-related biliary stones. ,  Durand-Fontanier It should be considered in the differential diagnosis of postcholecystectomy biliary colic and cholangitis. 1 Le Guyader Wolters Kluwer Health, Inc. and/or its subsidiaries. Migration of clips into the bile duct with resultant stone formations is well recognized. Most of such incidents have been reported as case reports. The … Computed tomography image showing the common bile (triangle) and surgical clip (arrow). The clinical manifestations were unique in that symptoms of obstructive jaundice were in fact caused by endo-clips which had migrated into the common bile duct, and the resulting choledochoduodenal fistula presented as persistant cholangitis. La présence d'un canal cystique trop long [2] Walker W.E., Avant G.R., Reynolds V.H. 800-638-3030 (within the USA), 301-223-2300 (outside of the USA). Since its introduction, surgical hemostatic clips have been widely used and are generally considered very safe. Biliary complications secondary to post-cholecystectomy clip migration: A review of 69 cases. The median number of migrated clip was one (range, one to six). Item Preview Lippincott Journals Subscribers please login with your username or email along with your password. 2. Pain was due either to biliary colic or to acute pancreatitis (case 2). 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. Valleix This is usually 'dropped' during this laproscopic procedure. Cholecystectomy was performed after cholangiography. It can occur at any time but typically occur at a median of 2 years after cholecystectomy. Chong VH, Yim HB, Lim CC. Cholecystectomy, that is removal of the gallbladder, is usually considered a safe operation, however there is a small risk of complications associated as is with all procedures. 1. All registration fields are required. Some error has occurred while processing your request. Late complications involve intra-abdominal bile leakage, sub-hepatic abscesses, retained bile duct stones, post-cholecystectomy syndrome and bile duct stricture [2]. Endoscopic retrograde cholangiopancreatography showing the common bile duct (triangle) and surgical clip (arrow). 1995;90(9):1521–4. Balloon sphincteroplasty was performed, and the cholecystectomy clip and adherent sludge were successfully removed via a balloon sweep (Figure 3). Cholecystectomy Clip Migration and Retrieval. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Robert Hawes Received: 9 August 2005 / Accepted: 13 October 2005 / Published online: 15 February 2007 Springer Science+Business Media, Inc. 2007 Keywords choledocholithiasis … Anesthésie, Réanimation, Médecine d'urgence, Biologie, Bactériologie, maladies infectieuses, Traitement chirurgical de la rectocèle antérieure de la femme.La voie périnéovaginale, Hémorragie digestive révélatrice d'un cancer du rein par métastases jéjunales multiples, P. Farthouat, S. Faucompret, C. Louis, P. Debourdeau, C. Pero, Y. Breda. The migration of a clip to the common bile duct after cholecystectomy is an uncommon, usually late, complication that can lead to diverse complications like stone formation, stenosis, and obstruction in the bile duct. We present a case, a 54-year-old woman, of clip-induced cholangitis resulting from surgical clip migration 12 months after laparoscopic cholecystectomy and laparoscopic common … Surgical clip migration following laparoscopic cholecystectomy as a cause of cholangitis. Conflict of Interest The author declares no conflict of interest related to this work. We report a case of recurrent AP (RAP) due to postcholecystectomy biliary clip migration and review all reported cases of postcholecystectomy biliar… migration of the clip through the wall of these organs or the surgical stump. Multiple cholecystectomy clip migration into the common bile duct causing obstructive jaundice This is usually 'dropped' during this laproscopic procedure. 1. Get new journal Tables of Contents sent right to your email inbox, Clinical and Translational Gastroenterology, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), September 2019 - Volume 6 - Issue 9 - p e00216, Cholecystectomy Clip Migration and Retrieval, Articles in PubMed by David Sanders, BSc, MD, Articles in Google Scholar by David Sanders, BSc, MD, Other articles in this journal by David Sanders, BSc, MD. It obviates the need for preoperative investigations looking for biliary stones and provides an excellent definition of the biliary anatomy for safety purposes. cholecystectomy, surgical clip migration is a well-documented event with several case reports published. Ligation of cystic artery and duct is usually performed with titanium surgical clips, which have the potential to migrate into the CBD with time and cause obstruction, stone formation, acute biliary pancreatitis, stenosis and cholangitis [ 2 , 3 ]. Clip migration into the common bile duct (CBD) is a rare but well-established phenomenon of laparoscopic biliary surgery. Clip; Common Bile Duct Stone; Laparoscopic Cholecystectomy; Migration . Our case shows that in case of recurrence of symptoms following cholecystectomy, clip migration should be considered in one ofthe differential diagnosis. We report a case of Hem-o-lok clips migration 1 year after laparoscopic cholecystectomy and laparoscopic common bile duct exploration (LC+LCBDE) with primary closure. A. Early complications of Laproscopic Cholecystectomy (LC) include hemorrhage, iatrogenic perforation of the gallbladder, CBD injury and iatrogenic bowel and vascular injuries [1]. Rarely one or more clips can get displaced. Keywords: Clip migration, Endoscopic retrograde cholangiopancreatography, Laparoscopic cholecystectomy, Mirizzi syndrome, Polymer laparoscopic clip, Post-cholecystectomy syndrome Background Gallstone disease is one of the most common digestive diseases; it affects over 10 % of the general population and leads to many cholecystectomies annually. J Gastrointest Surg. Chong VH, Chong CF. You may be trying to access this site from a secured browser on the server. ACG Case Reports Journal6(9):e00216, September 2019. Article gratuit. The symptoms may include abdominal pain, nausea, vomiting, anorexia, pruritus, jaundice and fever due to ascending cholangitis [3, 4, 7]. Endoscopic retrograde cholangiopancreatography luminal image of the surgical clip and debris. In most of the cases it does not result in complications, however intra abdominal abscess formation was reported in literature. CASE REPORT A 42-year-old male with a history of cerebral palsy, learning difficulties and epilepsy was admitted with a 24-h history of nausea, vomiting and abdominal pain. [1, 2] These symptoms can represent either the continuation of symptoms thought to be caused by gallbladder pathology or the development of new symptoms normally attributed to the gallbladder.PCS also includes the development of symptoms caused by removal of the … After admission, total bilirubin increased from 30 to 66 μmol/L, γ-glutamyltransferase to 852 U/L, alkaline phosphatase to 546 U/L, alanine aminotransferase to 312 U/L, and aspartate transaminase to 241 U/L. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers. The time of clip migration can vary from 11 days to 20 years, while the median time of migration is usually 2 years and the median number of the migrated clip is 1 (range 1–6) [ 3 ]. T. Murray provided the images. The time interval between the initial cholecystectomy and the development of complications due to endoclip migration varies from some days to 20 years. We hope that this case draws … No biliary injuries were observed. In most of the cases it does not result in complications, however intra abdominal abscess formation was reported in literature. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”. Sanders, David BSc, MD1; Murray, Timothy MD, MCh, MRCS, FFR, EBIR2; Byrne, Michael F. MA, MD, MRCP, FRCPC1, 1Department of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada, 2Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada. EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925. The described case gives us the opportunity to remind surgeons and endoscopists that biliary stones can be formed by the surgery-related materials in patients that have undergone previous biliary surgery. The mechanism and exact incidence of clip migration are both poorly understood. Registered users can save articles, searches, and manage email alerts. Tous droits réservés. The patient was successfully treated with endoscopic sphincterotomy plus balloon dilation (ESBD) and Hem-o-lok clips extraction. Financial disclosure: MF Byrne is the CEO and shareholder of Satis Operations Inc. His medical history was notable for a laparoscopic cholecystectomy for symptomatic cholelithiasis 6 years ago. His temperature was 38.5°C, and his white blood cell count was 6.0 × 109 cells/L. Cholecystectomy is one of the most common … Biliary Complications Secondary to Post-Cholecystectomy Clip Migration: A Review of 69 Cases | springermedizin.de Registrieren Login Studies showed that acute biliary obstruction with laparoscopic cholecystectomy is twice as common as acute biliary obstruction with open cholecystectomy because of misplaced or migrating surgical clips [ 8 ]. This study reviews a case of postcholecystectomy clip migra-tion. ERCP confirmed a linear radiopacity with a surrounding filling defect within the lower CBD (Figure 2). The migration of surgical clips after laparoscopic procedures was first reported in 1992, but such instances are extremely rare. Surgical clips as a nidus for biliary stone formation: Diagnosis and therapy. Surgical clip migration is an uncommon complication of laparoscopic cholecystectomy, which may occur days to years following surgery. Éditions scientifiques et médicales Elsevier SAS. Postcholecystectomy clip migration was first described in the literature in 1978. 7-15). References. The clinical manifestations were unique in that symptoms of obstructive jaundice were in fact caused by endo-clips which had migrated into the common bile duct, and the resulting choledochoduodenal fistula presented as persistant cholangitis. The common clinical symptoms of clip migration are right upper abdominal pain (approximately 70%–80% of cases), jaundice (approximately 50%–75%), and fever (approximately 30%) [3,6]. Introduction. B.  This study reviews a case of postcholecystectomy clip migration. During LC, surgical hemostatic clips placed on the cystic duct and … 2 Risk factors for postcholecystectomy clip migration include cholecystectomies with more than 4 surgical clips, previous complicated gallstone disease, inaccurate clip placement, and distorted anatomy. Clip migration into the common bile duct can cause recurrent cholangitis and serve as a nidus for stone formation. Surgical clips are applied during cholecystectomy on the cystic duct and artery. Background . Informed consent was obtained for this case report. to save searches, favorite articles and access email content alerts. Please enable scripts and reload this page. This clip caused choledocholithiasis in a patient 1 year after a laparoscopic cholecystectomy. 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