Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
A case of cystic duct stone with clip migration to the cystic duct after a laparoscopic cholecystectomy
Hideaki TSUBAKIHARARyuichiro UEMURAYoshiharu SHONOSatoru SAKAGUCHIHiroyuki TANISHIMAKatsuyoshi TABUSE
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2009 Volume 70 Issue 9 Pages 2772-2775

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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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© 2009 Japan Surgical Association
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