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Post-cholecystectomy Clip Migration: A Case Report.

Renisha Singh¹, Praveen Arumugam¹, Kushagra Mathur¹

¹Internal Medicine, Max Super Speciality Hospital, New Delhi, IND.

|May 20, 2024

Summary

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Endoscopic Procedures V: ERCP

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...

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Surgical clip migration into the common bile duct (CBD) is a rare complication after cholecystectomy. This case highlights successful endoscopic removal of a migrated clip causing biliary obstruction.

Area of Science:

Gastroenterology
Surgical Complications
Biliary System Imaging

Background:

Surgical clip migration into the common bile duct (CBD) is a rare complication post-cholecystectomy.
Fewer than 100 cases have been reported in medical literature.

Observation:

A 78-year-old female presented with abdominal pain and dark urine 6 years after open cholecystectomy.
Abdominal ultrasonography was unremarkable, but CT revealed a surgical clip in the CBD with a bile stone and another clip at the gallbladder fossa.

Findings:

Endoscopic retrograde cholangiopancreatography (ERCP) successfully removed the migrated CBD clip using SpyGlass cholangioscopy.
The patient's symptoms were attributed to the migrated clip and associated stone formation.

Keywords:

endoclipping endoscopic clip laparoscopic cholecystectomy. clip migration. hem-o-lok clip. common bile duct (cbd). endoscopic retrograde cholangiopancreatography (ercp). magnetic resonance cholangiopancreatography (mrcp)post operative complication post-ercp

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Implications:

Post-cholecystectomy clip migration (PCCM) should be considered in patients with obstructive jaundice or biliary colic.
Minimally invasive ERCP is the preferred treatment for migrated clip complications.
Vigilance and prompt intervention are crucial for managing potentially serious post-cholecystectomy complications.