BACKGROUND Hem-o-lok clips are typically used to control the cystic duct and vessels during laparoscopic cholecystectomy(LC)and common bile duct exploration for stones in the bile duct and gallbladder.Here,we report a...BACKGROUND Hem-o-lok clips are typically used to control the cystic duct and vessels during laparoscopic cholecystectomy(LC)and common bile duct exploration for stones in the bile duct and gallbladder.Here,we report a unique example of Hem-o-lok clip movement towards the duodenal bulb after LC,appearing as a submucosal tumor(SMT).Additionally,we provide initial evidence of gradual and evolving endoscopic manifestations of Hem-o-lok clip migration to the duodenal bulb wall and review the available literature.CASE SUMMARY A 72-year-old man underwent LC for gallstones,and Hem-o-lok clips were used to ligate both the cystic duct and cystic artery.Esophagogastroduodenoscopy(EGD)2 years later revealed an SMT-like lesion in the duodenal bulb.Due to the symptomatology,the clinical examination did not reveal any major abnormalities,and the patient was followed up as an outpatient.A repeat EGD performed 5 months later revealed an SMT-like lesion in the duodenal bulb with raised edges and a central depression.A third EGD was conducted,during which a Hem-o-lok clip was discovered connected to the front side of the duodenum.The clip was extracted easily using biopsy forceps,and no complications occurred.Two months after the fourth EGD,the scar was surrounded by normal mucosa.CONCLUSION Clinicians should be aware of potential post-LC complications.Hem-o-lok clips should be removed if symptomatic.展开更多
腹腔镜胆囊切除术(laproscopic cholecystectomy,LC)和腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)是胆囊和胆道疾病的重要治疗方法。闭合夹广泛用于胆囊管和胆囊血管的结扎。移位的金属夹和Hem-o-lok夹...腹腔镜胆囊切除术(laproscopic cholecystectomy,LC)和腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)是胆囊和胆道疾病的重要治疗方法。闭合夹广泛用于胆囊管和胆囊血管的结扎。移位的金属夹和Hem-o-lok夹多数是在外科手术中或留置的T管窦道经胆道镜探查发现,内镜逆行胰胆管造影术(endoscopic retrograde cholangiopan creatography,ERCP)术中发现Hem-o-lok夹移位至胆道的报道较为罕见。本文报道了1例ERCP术中成功取出移位至胆总管的Hem-o-lok夹的病例。展开更多
文摘BACKGROUND Hem-o-lok clips are typically used to control the cystic duct and vessels during laparoscopic cholecystectomy(LC)and common bile duct exploration for stones in the bile duct and gallbladder.Here,we report a unique example of Hem-o-lok clip movement towards the duodenal bulb after LC,appearing as a submucosal tumor(SMT).Additionally,we provide initial evidence of gradual and evolving endoscopic manifestations of Hem-o-lok clip migration to the duodenal bulb wall and review the available literature.CASE SUMMARY A 72-year-old man underwent LC for gallstones,and Hem-o-lok clips were used to ligate both the cystic duct and cystic artery.Esophagogastroduodenoscopy(EGD)2 years later revealed an SMT-like lesion in the duodenal bulb.Due to the symptomatology,the clinical examination did not reveal any major abnormalities,and the patient was followed up as an outpatient.A repeat EGD performed 5 months later revealed an SMT-like lesion in the duodenal bulb with raised edges and a central depression.A third EGD was conducted,during which a Hem-o-lok clip was discovered connected to the front side of the duodenum.The clip was extracted easily using biopsy forceps,and no complications occurred.Two months after the fourth EGD,the scar was surrounded by normal mucosa.CONCLUSION Clinicians should be aware of potential post-LC complications.Hem-o-lok clips should be removed if symptomatic.
文摘腹腔镜胆囊切除术(laproscopic cholecystectomy,LC)和腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)是胆囊和胆道疾病的重要治疗方法。闭合夹广泛用于胆囊管和胆囊血管的结扎。移位的金属夹和Hem-o-lok夹多数是在外科手术中或留置的T管窦道经胆道镜探查发现,内镜逆行胰胆管造影术(endoscopic retrograde cholangiopan creatography,ERCP)术中发现Hem-o-lok夹移位至胆道的报道较为罕见。本文报道了1例ERCP术中成功取出移位至胆总管的Hem-o-lok夹的病例。
