Abstract
Abstract
Background
Ligation clips are used for vessel or tissue ligation in surgery. Although previous reports have described the migration of metallic clips after hepato-biliary-pancreatic surgery, very few reports have described the migration of non-absorbable polymer clips (NAPCs: Hem-o-Lok).
Case presentation
We present 4 cases of NAPC migration that occurred after laparoscopic surgery. Case 1 was an 81-year-old woman that had undergone a laparoscopic right hemihepatectomy for an intrahepatic bile duct cyst adenocarcinoma at the age of 79 years. Two years after the operation, she underwent an upper gastrointestinal endoscopy to investigate epigastric pain. The endoscopy showed NAPCs lodged at the anterior side of the duodenal bulb. Case 2 was an 80-year-old man that had undergone a laparoscopic cholecystectomy for choledocholithiasis at the age of 77 years. Three years after the operation, follow-up computed tomography and magnetic resonance cholangiopancreatography (MRCP) imaging indicated a mass in the upper bile duct. After a laparoscopic bile duct resection and reconstruction, an NAPC was found inside the inflammatory pseudotumor. Case 3 was a 63-year-old man that had undergone laparoscopic liver S4b and S5 resections and lymph node dissection for gallbladder cancer. Three months after the operation, follow-up MRCP imaging suggested a bile duct stenosis. An endoscopic retrograde cholangiopancreatography (ERCP) was performed, and an NAPC was found inside the bile duct. Case 4 was a 74-year-old man that had undergone a laparoscopic S5 segmentectomy, S7 partial liver resection, and cholecystectomy for liver metastasis of lung cancer and cholelithiasis. A trans-cystic drainage tube was inserted, and it was ligated and fixed with NAPCs. Three months after the operation, follow-up MRCP imaging showed common bile duct stones (CBDS). An ERCP was performed, and two NAPCs were found with the CBDS.
Conclusions
Few previous reports have described complications due to NAPC migration after hepato-biliary-pancreatic surgery. However, with the widespread use of NAPC, postoperative complications due to NAPC migration are expected to increase in the near future. The differential diagnosis of complications should include potential NAPC migration in patients that have undergone laparoscopic surgery.
Publisher
Springer Science and Business Media LLC
Reference19 articles.
1. Umiker WO, Iverson L. Postinflammatory tumors of the lung: report of four cases simulating xanthoma, fibroma, or plasma cell tumor. J Thorac Surg. 1954;28:55–63.
2. Arber DA, Kamel OW, van de Rijn M, Davis RE, Medeiros LJ, Jaffe ES, et al. Frequent presence of the Epstein-Barr virus in inflammatory pseudotumor. Hum Pathol. 1995;26(10):1093–8.
3. Ishida T, Shinozaki H, Terauchi T, Kimata M, Kobayashi K, Ogata Y, et al. A Case of inflammatory pseudotumor of the mesentery that was difficult to differentiate from solitary lymph node recurrence after laparoscopic anterior resection for rectal cancer. J Jpn Surg Assoc. 2016;77(8):2011–5.
4. Kihara Y, Takeda Y, Katsura Y, Ohmura Y, Sakamoto T, Murata K. A case of inflammatory pseudotumor caused by non-absorbable polymer clip in laparoscopic cholecystectomy. Journal of Japan Society for Endoscopic Surgery. 2020;25(5):385–90.
5. Uehara H, Abe T, Hosokawa M, Kondo S, Kato H. Choledocholithiasis due to a migrated metal clip after laparoscopic cholecystectomy -report of a case. J Jpn Surg Assoc. 2001;62(2):487–90.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献