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Korean J Gastrointest Endosc. 1999 Feb;19(1):139-142. Korean. Case Report.
Hur BW , Choi CW , Kim KH , Kim YB , Kang CD , Kim CD , Ryu HS , Hyun JH .
Department of Internal Medicine, Korea University College of Medicine, Institute of Digestive Disease and Nutrition, Seoul, Korea.

Laparoscopic cholecystectomy has become the choice procedure for surgical removal of symptomatic gallbladder stones. However, with the introduction and use of this technique, unusual complications can be expected. Among them, the surgical clip has become a nidus for common bile duct (CBD) stone formation; it is a rare complication of laparoscopic or open cholecystectomy. We recently experienced a case of surgical clip migration into the CBD in a patient who underwent laparoscopic cholecystectomy. A 46-year-old woman was admitted due to right upper quadrant pain which had persisted for 1 week. A year earlier, she had undergone a laparoscopic cholecystectomy for acute cholecystitis due to gallbladder stones. On admission, physical examination revealed normal findings except subicteric sclera and minimal right upper quadrant tenderness. Laboratory evaluation determined abnormal liver functioning. Abdominal sonography revealed an echogenic density with acoustic shadows within a mildly dilated CBD. Endoscopic retrograde cholangiogram revealed a single CBD stone with two metallic surgical clips forming a nidus. The stone with clips was easily removed through the dilated ampulla of Vater orifice using a Dormia basket. There were no post-ERC complications and the patient was reportedly doing well.

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