Choledocholithiasis And Acute Cholangitis Following PostCholecystectomy Clip Migration

Abstract

Laparoscopic cholecystectomy is the standard of care in symptomatic cholelithiasis and it has been associated with complications such as bile duct injury, bleeding, bile leak and residual stones. Postcholecystectomy clip migration is an uncommon complication of laparoscopic cholecystectomy . It was first reported in 1992. We present a case report of a 48 years old lady presenting with right upper abdominal pain fever and vomiting. Patient had undergone an uncomplicated laparoscopic cholecystectomy 13 years earlier. Magnetic resconance cholangiopancreatography revealed non-visualization of lower common bile duct, thick bile and proximal dilatation. Patient was successfully managed with Endoscopic retrograde cholangiopancreatography to remove the stone with along with clip. Long-term follow-up should be done in post-cholecystectomy patients and cystic duct clip migration with eventual biliary complications should be considered as a differential diagnosis in symptomatic post-cholecystectomy patients.