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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 4/2010

01-04-2010 | Original Article

Biliary Complications Secondary to Post-Cholecystectomy Clip Migration: A Review of 69 Cases

Authors: Vui Heng Chong, Chee Fui Chong

Published in: Journal of Gastrointestinal Surgery | Issue 4/2010

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Abstract

Introduction

Post-cholecystectomy clip migration (PCCM) is rare and can lead to complications which include clip-related biliary stones. Most have been reported as case reports. This study reviews cases of clip migration reported in the literatures.

Method

Searches and reviews of the literatures from “PubMed,” “EMBASE,” and “Google Scholar” search engines using the keywords “clip migration” and “bile duct stones” were carried out. Eighty cases from 69 publications were identified but details for only 69 cases were available for the study.

Results

The median age at presentations of PCCM was 60 years old (range, 31 to 88 years; female, 61.8%) and the median time from the initial cholecystectomy to clinical presentations was 26 months (range, 11 days to 20 years). Of primary surgeries, 23.2% was for complicated gallstones disease. The median number of clips placed during surgery was six (range, two to more than ten clips). Common diagnoses at presentations of PCCM were obstructive jaundice (37.7%), cholangitis (27.5%), biliary colic (18.8%), and acute pancreatitis (8.7%). The median number of migrated clip was one (range, one to six). Biliary dilatation and strictures were encountered in 74.1% and 28.6%, respectively. Of the 69 cases of PCCM-associated complications, 53 (77%) were successfully treated with endoscopic retrograde cholangiopancreatography (ERCP), 14 (20.2%) with surgery, and one (1.4%) with successful percutaneous transhepatic cholangiography treatment. One patient had spontaneous clearance of PCCM. There was no reported mortality related to PCCM.

Conclusion

PCCM can occur at any time but typically occur at a median of 2 years after cholecystectomy. Clinical presentations are similar to those with primary or secondary choledocholithiasis. Most can be managed successfully with ERCP.
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Metadata
Title
Biliary Complications Secondary to Post-Cholecystectomy Clip Migration: A Review of 69 Cases
Authors
Vui Heng Chong
Chee Fui Chong
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 4/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-1131-0

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