An unusual complication of a dropped clip during laparoscopic cholecystectomy.
Dropped clips during laparoscopic cholecystectomy are not uncommon and although most surgeons would make attempts to retrieve them, this is not always straightforward and therefore such objects are on occasion left in the peritoneal cavity. Cystic duct clips or hemostatic clips migrating into the common bile duct after biliary surgery, although rare are well recognized and assumed to relate to improper clip application, bile leak (usually subclinical), inflammation, and subsequent necrosis, allowing the clips to erode directly into the common bile duct. We present a case of an open endoscopic clip, which was dropped at the time of an uncomplicated laparoscopic cholecystectomy, migrating into the common bile duct and causing partial biliary obstruction and its subsequently successful endoscopic removal.
Stephens
Michael
M
Department of Surgery, Princess of Wales Hospital, Bridgend, UK. mikestephens@doctors.org.uk
Ruddle
Angus
A
Young
W Tudor
WT
D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000295:instrumentation*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D013525:Surgical Instruments / Q000009:adverse effects*