A CASE OF CYSTIC DUCT STONE WITH CLIP MIGRATION TO THE CYSTIC DUCT AFTER A LAPAROSCOPIC CHOLECYSTECTOMY

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  • TSUBAKIHARA Hideaki
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center
  • UEMURA Ryuichiro
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center
  • SHONO Yoshiharu
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center
  • SAKAGUCHI Satoru
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center
  • TANISHIMA Hiroyuki
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center
  • TABUSE Katsuyoshi
    Department of Surgery, National Hospital Organization Osaka Minami Medical Center

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Other Title
  • 腹腔鏡下胆嚢摘出術後に胆嚢管へのクリップの迷入を伴った胆嚢管結石症の１例

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Abstract

A 52-year-old male had a laparoscopic cholecystectomy for cholecystolithiasis ten years previously ; the postoperative course was good. The patient developed right hypochondrial pain two months prior to being seen, and he visited the Department of Gastroenterology at our hospital. On abdominal CT, a high-intensity lesion was observed in the cystic duct. He was diagnosed as having a cystic duct stone. A laparoscopic excision of the cystic duct was done. Inside the cystic duct, two clips and two small stones were found, the clips had been used to ligate the cystic artery. There is an increasing number of reports of bile duct stones related to the migration of surgical clips, which become nuclei. A further increase in such cases is expected. The present case high light, the mechanisms of the migration. Clip migration is a complication that should be taken into consideration in patients with a laparoscopic cholecystectomy. In the future, ligation techniques and surgical instrumentation that do not involve the use of clips should be developed.

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