Liu DR, Wu JH, Shi JT, Zhu HB, Li C. Hem-o-lok clip migration to the common bile duct after laparoscopic common bile duct exploration: A case report. World J Clin Cases 2022; 10(19): 6548-6554 [PMID: 35979320 DOI: 10.12998/wjcc.v10.i19.6548]
Corresponding Author of This Article
Chao Li, MD, PhD, Chief Doctor, Surgeon, Surgical Oncologist, Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zjlichaoweb@zju.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2022; 10(19): 6548-6554 Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6548
Hem-o-lok clip migration to the common bile duct after laparoscopic common bile duct exploration: A case report
Da-Ren Liu, Jin-Hong Wu, Jiang-Tao Shi, Huan-Bing Zhu, Chao Li
Da-Ren Liu, Jin-Hong Wu, Jiang-Tao Shi, Huan-Bing Zhu, Chao Li, Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Liu DR, Wu JH, and Shi JT were the patient’s surgeons, reviewed the literature, and drafted the manuscript (contributed equally to this article); Zhu HB and Li C reviewed the literature and contributed to manuscript drafting; Liu DR and Li C were responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported byMedical and Health Technology Plan of Zhejiang Province, No. 2019RC179.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao Li, MD, PhD, Chief Doctor, Surgeon, Surgical Oncologist, Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zjlichaoweb@zju.edu.cn
Received: October 11, 2021 Peer-review started: October 11, 2021 First decision: March 14, 2022 Revised: March 18, 2022 Accepted: May 14, 2022 Article in press: May 14, 2022 Published online: July 6, 2022 Processing time: 256 Days and 3.9 Hours
Abstract
BACKGROUND
Laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) has been widely used for management of gallbladder and common bile duct (CBD) stones. Post-operative clip migration is a rare complication of laparoscopic biliary surgery, which can serve as a nidus for stone formation and cause recurrent cholangitis.
CASE SUMMARY
A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain. She has a history of LC and had a LCBDE surgery 2 mo ago. Physical examination revealed tenderness in the upper quadrant of right abdomen. Computed tomography scan demonstrated a high-density shadow at the distal CBD, which was considered as migrated clips. The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination, and two displaced Hem-o-lok clips were removed with a stone basket. No fever or abdominal pain presented after the operation. In addition to the case report, literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.
CONCLUSION
Incidence of postoperative clip migration may be reduced by using clips properly and correctly; however, new methods should be explored to occlude cystic duct and vessels. If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain, clip migration must be considered as one of the differential diagnosis.
Core Tip: Surgical clip migration is a rare complication of laparoscopic biliary surgery. Herein, we report a case of Hem-o-lok clip migration into the common bile duct after laparoscopic cholecystectomy and laparoscopic common bile duct exploration operation which were removed by a basket in endoscopic retrograde cholangiopancreatography. Furthermore, literature regarding clip migration post-laparoscopic biliary surgery were reviewed. We suggest that the incidence of postoperative clip migration may be reduced by using clips properly and correctly; however, new methods should be explored to occlude cystic duct and vessels.
