[Clip migration in the common bile duct and consecutive calculus formation after laparoscopic cholecystectomy]

In 1991 a 64-year old woman underwent laparoscopic cholecystectomy for symptomatic gallstones. The follow-up was uneventful. Two years later a painless obstructive jaundice appeared. Endoscopic retrograde cholangio-pancreatography revealed a freely floating surgical clip within the common bile duct. It was a FILSHIE-Clip, commonly used to ligate the cystic duct. The endoscopic extraction of the foreign body was unsuccessful because the clip slipped into a small intrahepatic bile duct. Smaller gallstones that had probably crystallized around the clip could be extracted. Finally the clip itself disappeared spontaneously after endoscopic sphincterotomy through the papilla. It is discussed why movement of a surgical clip into the common bile duct appears after laparoscopic cholecystectomy.