Hai S, Tanaka H, Kubo S, Takemura S, Kanazawa A, Tanaka S, Hirohashi K
Hepato-Biliary-Pancreatic and Gastroenterological Surgery, Osaka City University, Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Surg Endosc. 2003 Dec;17(12):2028-31. doi: 10.1007/s00464-003-4517-1. Epub 2003 Oct 23.
As experience with laparoscopic cholecystectomy (LC) has increased, so have the number and variety of complications. We report a case of choledocholithiasis caused by migration of a surgical clip applied during LC. A 57-year-old Japanese man who had undergone LC 6 years previously was referred to our hospital with pruritus and jaundice. Magnetic resonance cholangiopancreatography and ultrasonography revealed a solid mass in the common hepatic duct and dilatation of the intrahepatic bile ducts. Abdominal arteriography demonstrated interruption of the right hepatic artery by surgical clips. Five days after a biopsy of the mass was performed through a percutaneous transhepatic biliary drainage tube, the mass moved to the terminus of the common bile duct along with one of the surgical clips. A basket catheter was used to remove the mass via endoscopy. Despite the fact that other clips in the common hepatic duct were partially exposed, the patient has been well for 2 years with no additional interventions.
随着腹腔镜胆囊切除术（LC）经验的增加，并发症的数量和种类也在增加。我们报告一例因LC术中应用的手术夹移位导致胆总管结石的病例。一名67岁的日本男性在6年前接受了LC手术，因瘙痒和黄疸被转诊至我院。磁共振胰胆管造影和超声检查显示肝总管内有一实性肿块，肝内胆管扩张。腹部动脉造影显示右肝动脉被手术夹阻断。在通过经皮经肝胆道引流管对肿块进行活检5天后，肿块连同其中一个手术夹一起移至胆总管末端。通过内镜使用网篮导管取出了肿块。尽管肝总管中的其他夹子部分暴露，但患者在未进行额外干预的情况下已健康生活了2年。
