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Postcholecystectomy Biliary Clip Migration Causing Acute Pancreatitis.
Ami Panara1, Jodie A Barkin2, Jamie S Barkin2
1Division of Gastroenterology, University of Miami, Leonard M. Miller School of Medicine, Miami, FL.
ACG Case Reports Journal
|November 22, 2019
Summary
Biliary clip migration after gallbladder removal can cause acute pancreatitis (AP). This case highlights the importance of considering clip migration in recurrent AP, with plain radiographs aiding diagnosis and management.
Area of Science:
- Gastroenterology
- Surgical Complications
- Diagnostic Imaging
Background:
- Laparoscopic cholecystectomy is a common procedure for gallstones.
- Acute pancreatitis (AP) is a potential complication following biliary interventions.
- Biliary clip migration is a rare but recognized complication.
Observation:
- A patient presented with recurrent acute pancreatitis 15 and 19 months post-laparoscopic cholecystectomy.
- Imaging studies suggested the migration of a biliary clip.
- Suspected mechanisms involved clip migration at a site of surgical dehiscence.
Findings:
- The migration of a biliary clip was identified as the likely cause of recurrent AP.
- Plain radiography can be useful for detecting changes in endoclip number over time.
- Comparison with prior imaging is crucial for diagnosing clip migration.
Implications:
- Early and accurate diagnosis of biliary clip migration is essential for appropriate patient management.
- Considering clip migration in the differential diagnosis of post-cholecystectomy AP can prevent delayed treatment.
- Radiographic assessment plays a key role in confirming the diagnosis and guiding therapeutic strategies.
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