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Cholecystitis

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...

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Ischemic mass effect from biliary surgical clips.

Rod Mateo¹, Steven Tsai, Maria V Stapfer

¹Division of Transplantation and Hepatobiliary/Pancreatic Surgery, Department of Surgery, Keck-USC School of Medicine, Los Angeles, California, USA. rod.mateo.usc@tenethealth.com

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|February 13, 2008

Summary

Migrating surgical clips can cause biliary strictures through obstruction or stone formation. A newly identified mechanism, "clipomas," involves ischemic mass effect from clips, also leading to biliary tract strictures.

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Area of Science:

Gastroenterology and Hepatobiliary Surgery
Surgical Pathology

Background:

Migrating surgical clips in the hepatic hilum are established causes of biliary stricture.
Common mechanisms include direct intraluminal obstruction and secondary stone formation.

Observation:

Two cases of delayed biliary tract stricture following cholecystectomy are presented.
Surgical clips were found adjacent to the strictured area, not obstructing the lumen directly.
Histology supported an ischemic mass effect, termed "clipomas".

Findings:

Migrating surgical clips can cause biliary strictures via direct obstruction, stone formation, or "clipomas" resulting from ischemic mass effect.
Resection and Roux-en-Y hepatico-jejunostomy were successful treatment modalities for these cases.

Implications:

This expands the understanding of biliary stricture etiology secondary to surgical clips.
Recognizing "clipomas" is crucial for accurate diagnosis and effective management of post-cholecystectomy biliary complications.