Case Report: Clip migration induced recurrent choledocholithiasis after laparoscopic common bile duct exploration

Clip migration into the common bile duct (CBD) represents a rare yet severe complication after laparoscopic biliary surgery. Herein, we report a case of a 75-year-old male patient who previously received simultaneous laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) with T-tube drainage. The patient was admitted with upper abdominal pain and jaundice. Elevated inflammatory indicators and liver function enzymes indicated biliary obstruction complicated by cholangitis. Abdominal computed tomography (CT) revealed CBD stones and two intraductal high-density foreign bodies, highly suggestive of migrated surgical clips. After empirical antibiotic administration, the patient underwent emergent reoperative LCBDE and T-tube reinsertion on hospital day 2. Intraoperative exploration confirmed complete clearance of biliary stones, with one Hem-o-lok clip and one titanium clip embedded in the stones. The patient had an uneventful postoperative course and was discharged with a favorable prognosis. This case report combined with literature review further clarifies the etiological characteristics of clip migration, and provides practical references for the early prevention and individualized management of such rare biliary complications.