Titanium clip migration after cholecystectomy: original technique for laparoscopic transcystic extraction when endoscopic retrograde cholangiopancreatography fails

• Published in: Journal of surgical case reports Vol. 2020; no. 9; p. rjaa289
• Main Authors: Pantoja Pachajoa, Diana A, Bruno, Marco A, Doniquian, Alejandro M, Alvarez, Fernando A
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01-09-2020
• Subjects: Surgical Technique; laparoscopic transcystic extraction; complications; surgical clip migration; laparoscopic cholecystectomy; common bile duct stone
• ISSN: 2042-8812; 2042-8812
• DOI: 10.1093/jscr/rjaa289

Abstract
Surgical clip migration into the common bile duct (CBD) is a rare complication after laparoscopic cholecystectomy (LC). Few cases of surgical clip migration have been reported in the literature, and most of them have been successfully treated with endoscopic retrograde cholangiopancreatography (ERCP). We present a 71-year-old woman with 48 h of abdominal pain, jaundice and fever 6 years after laparoscopic cholecystectomy. She was diagnosed with common bile duct obstruction from surgical clip migration. After failure of ERCP, the patient was successfully treated with an innovative approach by laparoscopic transcystic extraction using endoscopic hose-type biopsy forceps. The presented technique was feasible and safe in expert hands, representing a valuable alternative to avoid the need of a choledochotomy in patients with unsuccessful ERCP.