Abstract
Laparoscopic cholecystectomy is the gold standard technique for treatment of cholelithiasis. Some complications related to surgery, as residual stones, bleeding and bile duct injury may occur. Another very rare described complication after cholecystectomy is surgical clip migration, which may lead to formation of a stone around the clip, the called “clip choledocholithiasis”. Case Report. We report a case of a 50-year-old female patient who presented with right upper quadrant pain, nausea, vomiting and choluria for 3 days. She had undergone a laparoscopic cholecystectomy with choledocotomy and common bile duct (CBD) stone removal 18 months earlier. Lab values were: White blood cell (WBC) 22,100, Hemoglobin 13.1; Total bilirubin 6.8, conjugated bilirubin 3.9, amylase 623. Abdominal ultrasound revealed dilated CBD (10.5mm) and showed a possible image of a stone on distal CBD. Endoscopic retrograde cholangiopancreatography (ERCP) was then performed and showed a metallic image in distal CBD. A Dormia basket successfully extracted the clip-core stone, alleviating the patient’s jaundice. Biopsies suggested biliary content. She was on antibiotics for 10 days and laboratory tests showed WBC 9,500.
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