Clip-stone and T clip-sinus post laparoscopic biliary surgery: Two case reports and review of the literature

Table 1 Literature review of Hem-o-lok clip migration into the biliary tract or duodenum after laparoscopic cholecystectomy and laparoscopic common bile duct exploration

Ref.	Case number	Age	Initial operations	Time to clip migration after initial surgery	Migration site	Clinical manifestation	Imaging approach	Treatment for the migrated clips
Liu et al[16], 2024	1	72	LC	2 years	Duodenum	Abdominal pain	EGD, CT	EGD, biopsy forceps
Zhu et al[22], 2024	1	72	LC	2 years, 2 months	CBD	Upper abdominal pain, fever	MRCP, CT, ERCP	ERCP, stone basket
Wu et al[7], 2024	4	62-88	LC + LCBDE	17 months-24 months	CBD	Varying degrees of epigastric pain (2/4), epigastric pain with chills and fever (2/4)	MRI, MRCP, CT	LCBDE (1/4); LCBD, adhesions removed (3/4)
Slim et al[23], 2023	1	88	LC	6 months	CBD	Asymptomatism	ERCP	ERCP, balloon catheter
Liu et al[8], 2022	1	59	LC + LCBDE	2 months	CBD	Fever, acute right upper abdominal pain.	CT, ERCP	ERCP, stone basket
Tan et al[9], 2021	1	72	LC + LCBDE	4 years	CBD, the hepatic bile duct	Abdominal pain	MRCP, ultrasound	LCBDE, T-tube drainage
Kihara et al[10], 2021	1	80	LC	3 years	CBD	Asymptomatism (Inflammatory pseudotumor)	CT, MRCP	Laparoscopic bile duct resection and reconstruction, removed by ERCP
Jiang et al[11], 2021	1	67	LCBDE	12 months	CBD	Acute right upper abdominal pain	CT	LCBDE, primary closure
Desai et al[12], 2021	1	74	LC	1.5 years	CBD	Abdominal pain, nausea, vomiting	Endoscopic ultrasound, CECT, ERCP	ERCP
Roh et al[13], 2019	1	65	LC	13 months	CBD	Upper abdominal pain, fever	CT, ERCP	ERCP, balloon catheter
Kou et al[14], 2019	1	84	LC+LCBDE	3 years	CBD	Upper abdominal pain, chills, hyperpyrexia	ERCP, ENBD, LCBDE	LCBDE, T-tube biliary drainage
Pang et al[15], 2019	6	31-83	LCBDE (5/6); LC (1/6)	2 months-1.5 years	CBD (3/6), T-tube sinus (3/6)	Asymptomatism (3/6); Right upper abdominal pain (3/6)	CT (1/6); Choledochoscopy (3/6); Abdominal ultrasound (1/6); T-tube cholangiography, digital subtraction angiography of the biliary tract (1/6)	Choledochoscope, reticular basket (3/6); Exploratory laparotomy, bile duct exploration, and J tube drainage (1/6); Roux-en-Y (1/6); PTBD and stent implantation (1/6)
Rou et al[24], 2018	1	53	LC	10 months	CBD	Abdominal pain	CT	ERCP, stone basket
Zheng et al[4], 2018	6	NA	LC + LCBDE T-tube drainage (4/6); LC + LCBDE primary closure (2/6)	6 weeks-50 months	Duodenum (1/6), CBD (5/6)	Abdominal discomfort (1/6); Jaundice (2/6); Asymptomatism (3/6)	EGD (1/6); Laparotomy operation (1/6); Choledochoscope (1/6); Choledochoscope check through T-tube sinus (3/6)	Not processed (1/6); Laparotomy operation, stone retrieving basket (1/6); LCBDE, stone basket (4/6)
Qu et al[25], 2017	1	54	LC + LCBDE, primary closure	12 months	CBD	Intermittent upper abdominal pain	MRCP, ERCP	ENBD tube was inserted after ESBD
Ribeiro et al[26], 2016	1	75	LC	2 years	CBD	Abdominal pain	Abdominal ultrasound, ERCP	ERCP, balloon sweep
Seyyedmajidi et al[27], 2013	1	41	LC	8 months	Duodenum	Severe abdominal pain	Upper gastrointestinal endoscopic	Upper gastrointestinal endoscopy, olympus grasping forceps

CBD: Common bile duct; CECT: Contrast-enhanced computed tomography; CT: Computed tomography; EGD: Esophagogastroduodenoscopy; ENBD: Endoscopic nasobiliary drainage; ERCP: Endoscopic retrograde cholangiopancreatography; ESBD: Endoscopic sphincterotomy plus balloon dilation; LC: Laparoscopic cholecystectomy; LCBDE: Laparoscopic common bile duct exploration; MRCP: Magnetic resonance cholangiopancreatography; MRI: Magnetic resonance imaging; NA: Not available; PTBD: Percutaneous transhepatic biliary drainage.