Samim Mehdi M, Armstrong Christopher P
Department of Surgery, St. James University Hospital, Leeds, United Kingdom.
Int J Surg. 2008 Dec;6(6):473-4. doi: 10.1016/j.ijsu.2006.06.007. Epub 2006 Aug 14.
Surgical clips may incorporate into the duodenal ulcer after laparoscopic cholecystectomy leading to a rare complication.
A 70-year-old woman, 15 years after laparoscopic cholecystectomy, developed weight loss, anemia and gastric outlet obstruction secondary to a chronic duodenal ulcer. Gastroscopy showed a clip in the ulcer bed. At surgery she was found to have gastric outlet obstruction and mobilization of the duodenum revealed a large ulcer with a migrated clip from the cystic duct in its base. The ulcer was excluded and the clip was removed. She was perfectly well at the follow-up after 2 months.
Migration of endo-surgical clips is a rare complication after laparoscopic surgery. Surgeons, gastroenterologists and radiologists should be aware of this late complication of laparoscopic cholecystectomy in cases of acute abdominal symptoms.
腹腔镜胆囊切除术后手术夹可能嵌入十二指肠溃疡，导致一种罕见的并发症。
一名70岁女性，在腹腔镜胆囊切除术后15年，出现体重减轻、贫血以及继发于慢性十二指肠溃疡的胃出口梗阻。胃镜检查显示溃疡底部有一个夹子。手术时发现她有胃出口梗阻，十二指肠游离显示一个大溃疡，其底部有一个从胆囊管移位过来的夹子。切除溃疡并取出夹子。2个月后的随访中她恢复良好。
内镜手术夹移位是腹腔镜手术后一种罕见的并发症。对于出现急性腹部症状的病例，外科医生、胃肠病学家和放射科医生应意识到腹腔镜胆囊切除术的这种晚期并发症。
