Kafle Pradip Kumar, Pokhrel Biraj, Bhattrai Tulsiram, Lamsal Manoj, Kafle Brindeswari, Jha Anurag, Hamal Rabin, Pathak Rahul
Department of Gastroenterology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Ann Med Surg (Lond). 2024 Jun 20;86(8):4898-4901. doi: 10.1097/MS9.0000000000002304. eCollection 2024 Aug.
Laparoscopic cholecystectomy is one of the common surgeries occurring worldwide and the gold standard for the management of gallstone disease. The non-absorbable surgical clips may slip and can migrate causing a variety of problems as such, choledocholithiasis.
The authors report a case of 43-year-old female who presented with the complaint epigastric pain. She had undergone cholecystectomy 7 years back for symptomatic cholelithiasis. Ultrasonography of the abdomen showed a dilated common bile duct following which endoscopic retrograde cholangiopancreatography was done. A single black-colored stone with the metal clip was retrieved.
Post-cholecystectomy clip migration should be considered as one of the differentials for choledocholithiasis. Ultrasonography of the abdomen shows the dilated common bile duct. Further management is done by endoscopic retrograde cholangiopancreatography.
Surgical clips acting as nidus for choledocholithiasis is rare these days but should be considered as one of the differentials for pain abdomen.
腹腔镜胆囊切除术是全球常见的手术之一,也是胆结石疾病治疗的金标准。不可吸收的手术夹可能会滑脱并移位,从而引发各种问题,如胆总管结石。
作者报告了一例43岁女性患者,主诉上腹部疼痛。她7年前因有症状的胆结石接受了胆囊切除术。腹部超声显示胆总管扩张,随后进行了内镜逆行胰胆管造影术。取出了一块带有金属夹的黑色结石。
胆囊切除术后夹子移位应被视为胆总管结石的鉴别诊断之一。腹部超声显示胆总管扩张。进一步的治疗通过内镜逆行胰胆管造影术进行。
如今,手术夹作为胆总管结石的病灶较为罕见,但应被视为腹痛的鉴别诊断之一。