Metallic clip migration and primary common duct stone formation after subtotal cholecystectomy

Presentation Notes

Presented at The Wisconsin Surgical Society, Virtual Annual Meeting, November 2020.


Background: An 82-year-old male presented with choledocholithiasis ten years following laparoscopic conversion to open subtotal cholecystectomy.

Summary: A primary common duct stone formation with the nidus of a surgical clip, termed “cat’s eye calculi,” is reported ten years after subtotal cholecystectomy for severe cholecystitis. Stone and surgical clip retrieval was accomplished by percutaneous transhepatic technique because of a prior Roux-en-Y gastric bypass. A review of possible mechanisms of clip migration, percutaneous transhepatic cholangiogram technique, and treatment of stone/clips within the biliary system is discussed.

Conclusion: Postcholecystectomy clip migration is a rare cause of common duct stone formation. It should be considered in the differential diagnosis of post-cholecystectomy biliary obstruction.


Case Report

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