Endoclips as Nidus for Choledocholithiasis Presenting 5 Years After Laproscopic Cholecystectomy

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Figure 1 a, b A middle-aged lady presented to our unit with progressively worsening jaundice of 5 days’ duration. There had been no preceding prodrome. Based on the clinical features and liver function tests she was diagnosed as having surgical obstructive jaundice. Ultrasound showed dilated intrahepatic biliary radicals and a common bile duct (CBD) dilated as far as the lower end. The patient had undergone laparoscopic cholecystectomy for gallstone disease 5 years previously. On endoscopic retrograde cholangiography it was found that she had a stone, for which surgical clips had served as a nidus, at the lower end of the CBD. The stone was removed endoscopically and the patient improved. The migration of surgical clips as a complication of laparoscopic cholecystectomy is a rare but increasingly diagnosed complication.

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