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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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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. |
format | Online Article Text |
id | pubmed-6561069 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
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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