腹腔鏡下胆嚢摘出術後の金属クリップを核とした総胆管結石の１例

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  • A CASE OF COMMON BILE DUCT STONE CAUSED BY A METAL CLIP AS A CORE AFTER LAPAROSCOPY-ASSISTED CHOLECYSTECTOMY

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The patient was a 66-year-old woman who had underwent laparoscopy-assisted cholecystectomy, incision of the common bile duct and C-tube drainage at another hospital 7.5 years earlier. She was seen at the hospital because of fever, serious upper abdominal pain, and nausea. Close exploration has disclosed a common bile duct stone involving a metal clip as its core. Hence we have performed incision of the common bile duct and T-tube drainage under laparotomy. The removed stone was an 18×11mm bilirubin calcium stone in the center of which a metal clip was identified. During surgery we identified only one clip in the surgical stump of the cystic artery at where two clips had to be, and the lost clip might cause the stone. The patient's postoperative course was uneventful, and she has been followed in the clinic without having recurrence.<br> There have been 27 cases of common bile duct stone caused by a metal clip as the core in this country. It was inferred from intraoperative findings that either of two clips at the surgical stump of the cystic artery might be drawn into the common bile duct in this case

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