Clip Migration Within the Common Duct After Laparoscopic Cholecystectomy: A Case of Transient Acute Pancreatitis in the Absence of Associated Stones

Cetta, Francesco; Lombardo, Francesco; Baldi, C.; Cariati, Andrea

doi:10.1055/s-2007-1004338

Cited by 18 publications

(16 citation statements)

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“…However, recent reports have described endo-clip migration into the common bile duct, causing stone formation as a rare late complication of LC. [7][8][9][10][11][12][13][14][15][16][17][18][19] Our review of the literature revealed that almost all cases of migrating clips involved metal clips. In this respect, a polymeric absorbable clip is advantageous because it degrades by hydrolysis within 6 months.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Absorbable Clips Compared with Metal Clips for Cystic Duct Ligation in Laparoscopic Cholecystectomy

et al. 2003

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Section: Introductionmentioning

confidence: 99%

Efficacy of Absorbable Clips Compared with Metal Clips for Cystic Duct Ligation in Laparoscopic Cholecystectomy

et al. 2003

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“…Inaccurately placed clips causing damage to the common bile duct, local inflammation and infection, bile leaks, and the use of Ͼ4 clips during surgery are known risk factors for clip migration. 28 Migrations tend to occur more frequently when laparoscopic cholecystectomy is performed for acute cholecystitis, supporting a partial inflammatory mechanism for migration. 11 Nonabsorbable polymer clips have been shown to elicit more inflammation than conventional staples in the appendices of rats, 29 suggesting that there may be a heightened risk associated with these types of clips, although the incidence of clip migration remains exceedingly rare.…”

Section: Discussionmentioning

confidence: 98%

Polymer Surgical Clip Migration Into the Trachea of an Infant

Hagopian¹,

Harmon²,

Clifton³

2014

CRSLS

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“…Cetta et al [14] reported a case of transient acute pancreatitis in the absence of associated stones 15 d after LC, probably due to spontaneous passage of an endoclip through the common bile duct. The case presented here is unique since stone formation and eventually acute pancreatitis occurred due to clip migration.…”

Section: Introductionmentioning

confidence: 99%

“…However, these methods have not yet been used commonly by surgeons probably due to the complication and high costs of their applications. Bile duct stones associated with migration of clips after LC are usually extracted during ERCP [2,8,14] . However, when ERCP fails or in cases with additional pathology, open surgery or percutaneous transhepatic cholangioscopy can be performed [8,18] .…”

Section: Introductionmentioning

confidence: 99%

Migrated endoclip and stone formation after cholecystectomy: A new danger of acute pancreatitis

Dolay¹,

Alış²,

Soylu³

et al. 2007

WJG

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A 56-year-old woman with mild right upper quadrant pain for 2 d was admitted to our hospital for acute onset of severe upper abdominal pain radiating to the back accompanied with vomiting for 12 h. On physical examination, she had no fever, the sclera was icteric, and there was tenderness on the right upper quadrant of the abdomen and the epigastric area with no rigidity and rebound pain. Her amylase and lipase levels were 2066 U/L and 1980 U/L, respectively. Her liver function tests were as follows: 5 mg/dL direct bilirubin, 303 IU/L gamma glutamyl transpeptidase, 135 IU/L alkaline phosphatase, 127 mg/dL glucose, 12 g/dL blood urea nitrogen, 170 IU/L lactate dehydrogenase, 8.6 mg/dL calcium, 3.8 g/dL albumin, 66 mmHg arterial Po2, 6800/μL white blood cells, 35% hematocrit , and 12 g/dL hemoglobin. She underwent selective noncomplicated LC 6 mo prior to this episode of acute pancreatitis.Plain abdominal X-rays showed three endoclips in the right upper quadrant, two of them were close to each other and one was located inferiomedially to the others. Abdominal ultrasonography (US) revealed that the common bile duct was dilated to 12 mm in diameter and the pancreas was swollen. The distal common bile duct could not be evaluated adequately by US.The patient was diagnosed as mild biliar y acute pancreatitis based on the modified Imrie criteria. After medical treatment was started, ERCP performed on the second day of admittance, demonstrated a stone (12 mm in diameter) and an imbedded surgical clip at the distal part of common bile duct which was dilated to 13 mm in diameter ( Figure 1A). A sphincterotomy of 15mm was performed. The extraction balloon catheter was easily burst when the stone was extracted. The stone was removed via a Dormia basket catheter (Figure 2A and B).Her symptoms improved on the first day after ERCP and the serum amylase level decreased to 250 IU/L. Her amylase levels and other biochemical parameters were normal on d 2 after ERCP and she was discharged from the hospital without any complications. There was no clinical or biochemical abnormality attributable to the biliary system or pancreas during the 1-year follow-up period after ERCP. DISCUSSIONAlthough the long term behavior of metal endoclips placed during LC is not clear, it is a well known-phenomenon AbstractEndoclip migration into the common bile duct following laparoscopic cholecystectomy (LC) is an extremely rare complication. Migrated endoclip into the common bile duct can cause obstruction, serve as a nidus for stone formation, and cause cholangitis. We report a case of obstructive jaundice and acute biliary pancreatitis due to choledocholithiasis caused by a migrated endoclip 6 mo after LC. The patient underwent early endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy and stone extraction.

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Clip Migration Within the Common Duct After Laparoscopic Cholecystectomy: A Case of Transient Acute Pancreatitis in the Absence of Associated Stones

Cited by 18 publications

References 0 publications

Efficacy of Absorbable Clips Compared with Metal Clips for Cystic Duct Ligation in Laparoscopic Cholecystectomy

Efficacy of Absorbable Clips Compared with Metal Clips for Cystic Duct Ligation in Laparoscopic Cholecystectomy

Polymer Surgical Clip Migration Into the Trachea of an Infant

Migrated endoclip and stone formation after cholecystectomy: A new danger of acute pancreatitis

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