Muehlenberg K, Löffler A
Innere Abteilung, Malteser-Krankenhauses Bonn.
Z Gastroenterol. 1995 Feb;33(2):108-11.
In 1991 a 64-year old woman underwent laparoscopic cholecystectomy for symptomatic gallstones. The follow-up was uneventful. Two years later a painless obstructive jaundice appeared. Endoscopic retrograde cholangio-pancreatography revealed a freely floating surgical clip within the common bile duct. It was a FILSHIE-Clip, commonly used to ligate the cystic duct. The endoscopic extraction of the foreign body was unsuccessful because the clip slipped into a small intrahepatic bile duct. Smaller gallstones that had probably crystallized around the clip could be extracted. Finally the clip itself disappeared spontaneously after endoscopic sphincterotomy through the papilla. It is discussed why movement of a surgical clip into the common bile duct appears after laparoscopic cholecystectomy.
1991年，一名64岁女性因有症状的胆结石接受了腹腔镜胆囊切除术。随访过程顺利。两年后出现无痛性梗阻性黄疸。内镜逆行胰胆管造影显示胆总管内有一个自由漂浮的手术夹。这是一个FILSHIE夹，常用于结扎胆囊管。由于夹子滑入了一条小的肝内胆管，内镜下取出异物未成功。可能在夹子周围结晶的较小胆结石被取出。最后，通过乳头进行内镜括约肌切开术后，夹子自行消失。文中讨论了腹腔镜胆囊切除术后手术夹为何会进入胆总管。
