scholarly journals Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 686-691 ◽  
Author(s):  
Anne M. Schreuder ◽  
Thomas M. van Gulik ◽  
Erik A.J. Rauws
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Stone Formation ◽  
Rare Complication ◽  
Arterial Embolization ◽  
Stone Extraction ◽  
Pseudo Aneurysm ◽  
The Common ◽  
The Right ◽  
And Function

Clips inserted during laparoscopic cholecystectomy (LC) may migrate into the biliary system and function as a nidus for the formation of gallstones. Here, we present a series of 4 patients who presented with this rare complication 5–17 years after LC. All 4 patients presented with symptomatic choledocholithiasis with biochemical and radiological signs of biliary obstruction. Three patients also had fever and infectious parameters, compatible with concurrent cholangitis. All patients successfully underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy and stone extraction. Patients with cholangitis also had antibiotic treatment. In 3 patients, obstruction of the common bile duct was caused by a single, relatively large stone that had formed around a clip (supposedly the cystic duct clip). In 1 patient, multiple stones had formed around an intrabiliary migrated cluster of coils that had been used for arterial embolization of a pseudo-aneurysm of the right hepatic artery. In conclusion, surgical clips and coils can migrate into the biliary tract and serve as a nidus for the formation of bile duct stones. Although rare, this complication should caution surgeons not to place clips “at random” during cholecystectomy. Patients with this rare complication are best managed by ERCP in combination with sphincterotomy and stone extraction.

scholarly journals Common bile duct stone development due to a Hem-o-lok clip migration: a rare complication of laparoscopic cholecystectomy

2019 ◽  
Vol 12 (7) ◽  
pp. e230178
Author(s):  
Yong Jun Roh ◽  
Jong Whan Kim ◽  
Tae Joo Jeon ◽  
Ji Young Park
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Stone Formation ◽  
Rare Complication ◽  
Acute Cholangitis ◽  
Balloon Catheter ◽  
Wall Thickening ◽  
Surgical Clip ◽  
Upper Abdominal

Surgical clip migration is a rare complication of laparoscopic cholecystectomy (LC). Surgical clips migrating into the common bile duct (CBD) can lead to stone formation and obstruction. Here, we report a case of acute cholangitis caused by surgical Hem-o-lok clip migration into the bile duct with stone formation 13 months after LC. A 65-year-old man who underwent LC presented with upper abdominal pain and fever for 3 days. Abdominal CT scan showed a radiopaque material in the CBD, diffuse wall thickening and dilatation of intrahepatic and extrahepatic duct. Emergency percutaneous transhepatic biliary drainage was performed. Twodays later, an endoscopic retrograde cholangio-pancreatography was implemented, and muddy stones and one surgical clip were successfully removed by extraction balloon catheter.

scholarly journals Hem-o-lok Clips Migration: An Easily Neglected Complication after Laparoscopic Biliary Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Jun-wen Qu ◽  
Gui-yang Wang ◽  
Zhi-qing Yuan ◽  
Ke-wei Li
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
Stone Formation ◽  
Common Bile Duct Exploration ◽  
Biliary Surgery ◽  
Surgical Clip ◽  
The Common

Clip migration into the common bile duct (CBD) is a rare but well-established phenomenon of laparoscopic biliary surgery. The mechanism and exact incidence of clip migration are both poorly understood. Clip migration into the common bile duct can cause recurrent cholangitis and serve as a nidus for stone formation. 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 bile duct exploration (LC+LCBDE) with primary closure.

scholarly journals Common Bile Duct Stone Formed around a Migrated Clip: An Unexpected Complication of Laparoscopic Cholecystectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Anas M. Hussameddin ◽  
Iba Ibrahim AlFawaz ◽  
Reema Fahad AlOtaibi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Bile Duct Stone ◽  
Stone Formation ◽  
Endoscopic Retrograde ◽  
Presenting Symptoms ◽  
Surgical Clip ◽  
The Common

Surgical clip migration into the common bile duct with subsequent stone formation is a rare complication following laparoscopic cholecystectomy. Very few cases have been reported in the literature. We report a case of bile duct stone formation around a migrated surgical clip 16 years after laparoscopic cholecystectomy. The patient presented with right upper quadrant pain, fever, and chills for one week. Investigation with abdominal ultrasound showed dilatation of the common bile duct and moderate dilatation of the intrahepatic bile ducts. The diagnosis was confirmed by endoscopic retrograde cholangiopancreatography and the patient was managed successfully with sphincterotomy and stone extraction. The exact mechanism of clip migration is not fully understood. Presenting symptoms are similar to non-clip-induced choledocholithiasis. Time of presentation can vary significantly with an average of 26 months. Most cases reported in the literature required surgical intervention. Clip migration should be considered in the differential diagnosis of postcholecystectomy biliary colic and cholangitis. Management with endoscopic retrograde cholangiopancreatography is the treatment of choice.

scholarly journals Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Natalie E. Cookson ◽  
Reza Mirnezami ◽  
Paul Ziprin
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Rare Complication ◽  
Acute Cholangitis ◽  
Gallstone Formation ◽  
Quadrant Pain ◽  
Surgical Clips ◽  
Surgical Clip ◽  
Symptomatic Gallstones ◽  
The Common

Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”.Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT) imaging revealed hyperdense material in the common bile duct (CBD) compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP) revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient’s jaundice and sepsis.Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.

Hemobilia following laparoscopic cholecystectomy: computed tomography findings and clinical outcome of transcatheter arterial embolization

2016 ◽  
Vol 58 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Wen Feng ◽  
Dong Yue ◽  
Lu ZaiMing ◽  
Liu ZhaoYu ◽  
Li Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Success Rate ◽  
Transcatheter Arterial Embolization ◽  
Arterial Embolization ◽  
Abdominal Ct ◽  
High Attenuation ◽  
Ct Findings ◽  
The Right

Background Hemobilia following laparoscopic cholecystectomy (LC) can occur in the early or late postoperative course and poses a diagnostic and therapeutic challenge. Purpose To assess computed tomography (CT) findings and clinical outcomes after transcatheter arterial embolization (TAE) in patients presenting with hemobilia following LC. Material and Methods Fourteen patients treated for hemobilia following LC were included in the study. Three patients were diagnosed by endoscopy and 11 by abdominal contrast-enhanced CT. Coils or microcoils were superselectively deployed to occlude the bleeding vessel during TAE. Abdominal CT findings of hemobilia, and the success rate and complication of TAE were observed. Results Abdominal CT provided the following signs of hemobilia: hematoma within the abdominal cavity and gallbladder fossa, blood clots containing high attenuation within the bile duct, biliary dilatation, pseudoaneurysm of the right hepatic artery, contrast extravasation, enhancement of the bile duct wall, and hypoperfusion of the right lobe. The success rate of TAE was 100% and rebleeding did not occur in any patient. Post-embolization syndrome and hepatic ischemia occurred in nine patients, which was associated with age and the time interval between the LC and TAE. Conclusion Abdominal CT provided direct signs that can aid in the diagnosis of hemobilia after LC. TAE allowed for successful treatment of hemobilia with minor complications.

scholarly journals Anatomy and Surgical Relevance of Rouviere’s Sulcus

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Raja Dahmane ◽  
Abdelwaheb Morjane ◽  
Andrej Starc
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Liver Resection ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Anatomical Landmark ◽  
Vascular Control ◽  
Open Type ◽  
The Common ◽  
The Mean ◽  
The Right

Rouviere’s sulcus (RS) (i.e., incisura hepatis dextra, Gans incisura) represents an important anatomical landmark. The aim of the study was to determine the frequency of the RS, its description, its location, its relations to the right portal pedicle and to the plane of the common bile duct, and the evaluation of the surgical relevance of the obtained data. Forty macroscopically healthy and undamaged livers were removed during autopsies from cadavers of both sexes. The RS was present in 82% of the cases and in these the open RS was identified in 70% of the livers. The fused type was observed in 12% of the cases; 18% of the livers had no sulcus. The mean length of the open type RS was 28 ± 2 mm (range 24–32 mm) and its mean depth was 6 ± 2 mm (range 4–8 mm). The right posterior sectional pedicle was found in the RS in 70% of the cases. In 5% of the livers, we also dissected a branch of the anterior sectional pedicle. Inside 25% of the RS, we found the vein of segment 6. The RS identification may avoid bile duct injury during laparoscopic cholecystectomy and enables elective vascular control during the right liver resection.

scholarly journals Titanium clip migration after cholecystectomy: original technique for laparoscopic transcystic extraction when endoscopic retrograde cholangiopancreatography fails

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Diana A Pantoja Pachajoa ◽  
Marco A Bruno ◽  
Alejandro M Doniquian ◽  
Fernando A Alvarez
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Rare Complication ◽  
Endoscopic Retrograde ◽  
Duct Obstruction ◽  
Surgical Clip ◽  
Common Bile Duct Obstruction ◽  
The Common

Abstract Surgical clip migration into the common bile duct (CBD) is a rare complication after laparoscopic cholecystectomy (LC). Few cases of surgical clip migration have been reported in the literature, and most of them have been successfully treated with endoscopic retrograde cholangiopancreatography (ERCP). We present a 71-year-old woman with 48 h of abdominal pain, jaundice and fever 6 years after laparoscopic cholecystectomy. She was diagnosed with common bile duct obstruction from surgical clip migration. After failure of ERCP, the patient was successfully treated with an innovative approach by laparoscopic transcystic extraction using endoscopic hose-type biopsy forceps. The presented technique was feasible and safe in expert hands, representing a valuable alternative to avoid the need of a choledochotomy in patients with unsuccessful ERCP.

Mechanical jaundice caused by common bile duct obstruction due to hepato-biliary ascariasis

2021 ◽  
pp. 20-24
Author(s):  
Zaipula Zulbegovich Nazhmudinov ◽  
Abdulkamal Guseynovich Guseynov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Surgical Intervention ◽  
Duct Obstruction ◽  
Biliary Ascariasis ◽  
Modern Methods ◽  
Common Bile Duct Obstruction ◽  
The Common ◽  
The Right

The paper presents a case of successful surgical treatment of a patient with common bile duct ascariasis, which caused obstructive jaundice. Modern methods of examining a patient with obstructive jaundice did not allow to make the right diagnosis of the common bile duct ascariasis before surgical intervention. The rarity of this pathology arouses interest in this material.

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