A Case of Postoperative Bile Duct Stone by Aberrant Surgical Clip after Laparoscopic Cholecystectomy

Hideo Takahashi, Kenji Yokoi, Masanari Wada, Tarou Yamato, Naoki Miyamoto, Shinji Higashide, Kouzou Uozu, Hiroshi Hasegawa, Hiroshi Sekikawa

The patient was a 79-year-old man who consulted our department with jaundice as the chief complaint. He had received laparoscopic cholecystectomy for cholelithiasis 7 months previously. Biochemical examination of his blood sample showed disturbance of hepatic function and an increase in biliary enzymes. Abdominal ultrasonography revealed an enlarged intrahepatic bile duct and common bile duct, and abdominal CT demonstrated metallic density in the lower part of the common bile duct. PTCD showed 2 calculus-like shadowy defects in the common bile duct, in each of which there were total of 3 clips previously been used. As treatment (total twice), we performed endoscopic papillotomy and lithectomy using smashing basket forceps and removed the common bile duct stones, which were relatively soft bilirubin stones. One clip was taken back. This case is a very rare complication according to the literature. However, in accordance with the prevalence of laparoscopic cholecystectomy, such cases will increase and should thus be kept in mind.

Key words
postoperative complication, laparoscopic cholecystectomy, aberrant surgical clip

Reprint requests
Hideo Takahashi Department of Surgery, Toyama Red Cross Hospital
1-5-25 Higashidenjigatamachi, Toyama City, 930 JAPAN

Accepted
September 13, 1995

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