Related Experiment Video
Updated: May 10, 2026
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Hem-o-Lok Clip in the First Part of Duodenum after Laparoscopic Cholecystectomy
Mohammadreza Seyyedmajidi1, Seyed Ashkan Hosseini, Shahin Hajiebrahimi
1Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran.
Insights
Hem-o-Lok clips used in laparoscopic cholecystectomy can migrate post-surgery, causing complications like severe abdominal pain. This case highlights potential safety concerns with Hem-o-Lok ligation during this common procedure.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Surgical Device Safety
Background:
- Laparoscopic cholecystectomy (LC) and common bile duct exploration (LCBDE) are standard procedures for gallstones.
- Hem-o-Lok clips are commonly used to ligate the cystic duct and vessels during LC.
Purpose of the Study:
- To report a case of Hem-o-Lok clip migration after laparoscopic cholecystectomy.
- To evaluate the safety of Hem-o-Lok clips in laparoscopic cholecystectomy.
Main Methods:
- A patient presented with severe abdominal pain 8 months after LC.
- Upper gastrointestinal endoscopy revealed two migrated Hem-o-Lok clips in the duodenum.
Main Results:
- The migrated Hem-o-Lok clips were identified in the anterior wall of the first part of the duodenum.
- The patient's symptoms were attributed to the clip migration.
Conclusions:
- Hem-o-Lok clips can migrate during the postoperative period following laparoscopic cholecystectomy.
- Hem-o-Lok ligation may not be a consistently safe method for controlling the cystic duct and vessels in LC.
Abstract:
Laparoscopic cholecystectomy (LC) and common bile duct exploration (LCBDE) have become the standard surgical procedure for cholecystolithiasis and choledocholithiasis. During the operation, cystic duct and vessels are usually controlled by Hem-o-Lok clips. We report a case with a complaint of severe abdominal pain for the previous 20 days. Her medical history was unremarkable except for laparoscopic cholecystectomy 8 months ago. In upper gastrointestinal endoscopy, two Hem-o-Lok clips at anterior wall of the first part of duodenum were detected. Therefore, the clip can migrate during postoperative period and Hem-o-Lok is not a very safe ligation method during laparoscopic cholecystectomy.
