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Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017

INTRODUCTION: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe...

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Autores principales: Pang, Liwei, Yuan, Jindong, Zhang, Yan, Wang, Yuwen, Kong, Jing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561069/
https://www.ncbi.nlm.nih.gov/pubmed/29794362
http://dx.doi.org/10.4103/jmas.JMAS_53_18
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author Pang, Liwei
Yuan, Jindong
Zhang, Yan
Wang, Yuwen
Kong, Jing
author_facet Pang, Liwei
Yuan, Jindong
Zhang, Yan
Wang, Yuwen
Kong, Jing
author_sort Pang, Liwei
collection PubMed
description INTRODUCTION: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe on most occasions and has few perioperative complications such as major bleeding, wound infection, bile leakage, and biliary and bowel injury. However, a rare complication of post-cholecystectomy clip migration (PCCM) increases year by year due to the advancement and development of LC, CBD exploration as well as the wide use of surgical ligation clips. MATERIALS AND METHODS: Six patients whose clips are found dropping into CBD or forming T-tube sinus after laparoscopic surgery in our department. RESULTS: Six patients whose clips are found dropping into CBD (clip-stone) (3/6) or forming T-tube sinus (T clip-sinus) (3/6) after LCBDE or LC. CONCLUSIONS: PCCM is a rare but severe complication of LCBDE. A pre-operative understanding of bile duct anatomy, the use of the minimum number of clips and the harmonic scalpel during the surgeries is necessary. Considering clip-stone or clip-sinus in the differential diagnosis of patients with biliary colics or cholangitis after LCBDE even years after surgery, the detailed medical history and pre-operative examination are inevitable, especially for these patients who had undergone LCBDE.
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spelling pubmed-65610692019-07-01 Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017 Pang, Liwei Yuan, Jindong Zhang, Yan Wang, Yuwen Kong, Jing J Minim Access Surg Original Article INTRODUCTION: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe on most occasions and has few perioperative complications such as major bleeding, wound infection, bile leakage, and biliary and bowel injury. However, a rare complication of post-cholecystectomy clip migration (PCCM) increases year by year due to the advancement and development of LC, CBD exploration as well as the wide use of surgical ligation clips. MATERIALS AND METHODS: Six patients whose clips are found dropping into CBD or forming T-tube sinus after laparoscopic surgery in our department. RESULTS: Six patients whose clips are found dropping into CBD (clip-stone) (3/6) or forming T-tube sinus (T clip-sinus) (3/6) after LCBDE or LC. CONCLUSIONS: PCCM is a rare but severe complication of LCBDE. A pre-operative understanding of bile duct anatomy, the use of the minimum number of clips and the harmonic scalpel during the surgeries is necessary. Considering clip-stone or clip-sinus in the differential diagnosis of patients with biliary colics or cholangitis after LCBDE even years after surgery, the detailed medical history and pre-operative examination are inevitable, especially for these patients who had undergone LCBDE. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6561069/ /pubmed/29794362 http://dx.doi.org/10.4103/jmas.JMAS_53_18 Text en Copyright: © 2018 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pang, Liwei
Yuan, Jindong
Zhang, Yan
Wang, Yuwen
Kong, Jing
Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title_full Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title_fullStr Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title_full_unstemmed Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title_short Clip-stone and T clip-sinus: A clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
title_sort clip-stone and t clip-sinus: a clinical analysis of six cases on migration of clips and literature review from 1997 to 2017
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561069/
https://www.ncbi.nlm.nih.gov/pubmed/29794362
http://dx.doi.org/10.4103/jmas.JMAS_53_18
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