Migration and slipping of metal clips after celioscopic cholecystectomy

Most surgeons performing in laparoscopic cholecystectomy have opted for the use of metal clips to secure the cystic duct before division. Accordingly, we have been using double proximal clipping of the cystic duct for our patients. Certain disadvantages of clips are well known, among them, their ability to slip. We report one case of clip migration into the common bile duct, which led to obstructive jaundice. The clip was recovered after endoscopic sphincterotomy. Slipping of the second metal clip lead to biliary peritonitis necessitating surgical drainage. The case presented raises the question of whether suture ligation of the proximal end of the cystic duct should be preferred to clipping.