Ng Daniel Yee Lee, Petrushnko Wilson, Kelly Michael Denis
Department of Surgery, Albury Wodonga Health, Albury, NSW, Australia.
JSLS. 2020 Jan-Mar;24(1). doi: 10.4293/JSLS.2019.00053.
Foreign material in the biliary tree may serve as a nidus for stone formation and would usually present as choledocholithiasis with jaundice or cholangitis. Overall it is a rare occurrence, but there are many anecdotal reports of ingested matter or surgical material such as suture or clips causing biliary stones. Especially interesting are the cases in which there is migration of a metallic clip used in laparoscopic cholecystectomy. Cholecystectomy is such a common operation that although the phenomenon is rare, it is important because it is preventable, and as such a review of the topic seems worthwhile.
The available literature was searched using the EMBASE and Ovid databases and reviewed. The various devices and sutures used to occlude the cystic duct in laparoscopic cholecystectomy are discussed with reference to their safety.
We found that the harmonic scalpel is a reasonable alternative with minimal complications but is however limited by cost. Electrosurgical vessel-sealing, ultrasonic shears, absorbable sutures such as endoloops (PDS), and polymer clips as well absorbable magnesium-calcium-zinc alloy clip are discussed.
胆管树中的异物可能成为结石形成的病灶，通常表现为伴有黄疸或胆管炎的胆总管结石。总体而言，这是一种罕见情况，但有许多关于摄入物质或手术材料（如缝线或夹子）导致胆石症的轶事报道。特别有趣的是腹腔镜胆囊切除术中使用的金属夹发生移位的病例。胆囊切除术是一种非常常见的手术，尽管这种现象很少见，但因其可预防而很重要，因此对该主题进行综述似乎是值得的。
使用EMBASE和Ovid数据库检索并回顾现有文献。参照其安全性讨论了腹腔镜胆囊切除术中用于封闭胆囊管的各种器械和缝线。
我们发现超声刀是一种合理的选择，并发症最少，但受成本限制。文中讨论了电外科血管闭合器、超声剪刀、可吸收缝线（如Endoloop（PDS））、聚合物夹以及可吸收镁钙锌合金夹。
