Most of such incidents have been reported as case reports. Suspecting ascending cholangitis secondary to an obstructing migrated cholecystectomy clip, fluid resuscitation and broad-spectrum antibiotic coverage were commenced and ERCP was performed. 2 Risk factors for postcholecystectomy clip migration include cholecystectomies with more than 4 surgical clips, previous complicated gallstone disease, inaccurate clip placement, and distorted anatomy. Chong VH, Chong CF. This study reviews a case of postcholecystectomy clip migra-tion. Cholecystectomy, that is removal of the gallbladder, is usually considered a safe operation, however there is a small risk of complications associated as is with all procedures. Biliary dilatation and strictures were encountered in 74.1% and 28.6%, respectively. Author contributions: D. Sanders wrote the manuscript, reviewed the literature, and is the article guarantor. References. Durand-Fontanier Cholecystolithiasis develops easily in the bile duct and can develop due to the presence of a foreign substance, such as artificial silk, inside the bile duct [1]. The delay between laparoscopic cholecystectomy and the first symptoms due to cystic duct clip migration ranged from 5 to 12 months. Studies showed that acute biliary obstruction with laparoscopic cholecystectomy is twice as common as acute biliary obstruction with open cholecystectomy because of misplaced or migrating surgical clips [ 8 ]. The patient improved uneventfully following the procedure. Migration of the clips into the common bile duct can lead to stone formation and obstruction. Postcholecystectomy clip migration was first described in the literature in 1978.1 Clips may migrate via the biliary tree, via a duodenal ulcer, or even by a clip embolism.2 Risk factors for postcholecystectomy clip migration include cholecystectomies with more than 4 surgical clips, previous complicated gallstone disease, inaccurate clip placement, and distorted anatomy.2 The pathophysiology is thought to be related to cystic stump necrosis and movement of the clip to a low-pressure system via the CBD.3 Management options include ERCP, percutaneous biliary cholangiogram (PTC) with biliary drain placement, and surgery.2,4 ERCP is the preferred mode of removal because even when not initially successful, it can allow for delayed spontaneous passage.2 The patient's blood cultures were negative, and he was discharged home on a course of antibiotics with resolution of all symptoms. Data is temporarily unavailable. Image of the surgical clip after extraction from the patient. Rarely one or more clips can get displaced. In one patient, the clip dropped from the duodenum after 2 months; the … 1. Anesthésie, Réanimation, Médecine d'urgence, Biologie, Bactériologie, maladies infectieuses, Traitement chirurgical de la rectocèle antérieure de la femme.La voie périnéovaginale, Hémorragie digestive révélatrice d'un cancer du rein par métastases jéjunales multiples, P. Farthouat, S. Faucompret, C. Louis, P. Debourdeau, C. Pero, Y. Breda. Wolters Kluwer Health © 2000  Bienvenue sur EM-consulte, la référence des professionnels de santé. The … All rights reserved. Multiple cholecystectomy clip migration into the common bile duct causing obstructive jaundice Cholangitis with a silver lining. Migration of metal clips into the duodenum after laparoscopic cholecystectomy is rare. The migration of a clip to the common bile duct after cholecystectomy is an uncommon, usually late, complication that can lead to diverse complications like stone formation, stenosis, and obstruction in the bile duct. We herein present two cases of migration of metal clips into the duodenum in patients who developed upper quadrant discomfort and a poor appetite after laparoscopic cholecystectomy. 2010;14(4):688–96. 800-638-3030 (within the USA), 301-223-2300 (outside of the USA). to maintaining your privacy and will not share your personal information without … migration of surgical clips is a rare complication and may result in complications, however abdominal! & # x201D ; ultrasound and therapeutic endoscopic retrograde cholangiopancreatography ( ERCP ) not cholecystectomy clip migration symptoms in,..., la référence des professionnels de santé.L ’ accès au texte intégral de article... 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