The wide use of surgical endoclips in laparoscopic surgery has led to a variety of complications.Postcholecystectomy endoclips migrating into the common bile duct after laparoscopic cholecystectomy is rare.A migrated ...The wide use of surgical endoclips in laparoscopic surgery has led to a variety of complications.Postcholecystectomy endoclips migrating into the common bile duct after laparoscopic cholecystectomy is rare.A migrated endoclip can cause obstruction,serve as a nidus for stone formation,and cause cholangitis.While the exact pathogenesis is still unknown,it is probably related to improper clip application,subclinical bile leak,inflammation,and subsequent necrosis,allowing the clips to erode directly into the common bile duct.We present a case of endoclip migrating into the common bile duct and duodenum,resulting in choledochoduodenal fistula after laparoscopic cholecystectomy and a successful reconstruction of the biliary tract by a hepaticojejunostomy with a Roux-en-Y procedure.This case shows that surgical endoclips can penetrate into the intact bile duct wall through serial maceration,and it is believed that careful application of clips may be the only way to prevent their migration after laparoscopic cholecystectomy.展开更多
Duodenal fistula refers to the pathological channel formed between the duodenum and the hollow viscera of the human body.If it is connected to a single cavity organ,it is a simple duodenal fistula.If it is connected t...Duodenal fistula refers to the pathological channel formed between the duodenum and the hollow viscera of the human body.If it is connected to a single cavity organ,it is a simple duodenal fistula.If it is connected to≥2 and the hollow viscera are connected,it is a complicated internal duodenal fistula,but simple ones are more common.Once a duodenal fistula develops,it establishes a pathological communication between duodenal contents and related organs,resulting in compromised organ function,infections,malnutrition,bleeding,and other detrimental effects.A patient with choledocholithiasis and choledochoduodenal fistula was treated in our hospital.She underwent laparoscopic left hemi-hepatectomy+laparoscopic choledochojejunostomy and was discharged 4 days after surgery.展开更多
文摘The wide use of surgical endoclips in laparoscopic surgery has led to a variety of complications.Postcholecystectomy endoclips migrating into the common bile duct after laparoscopic cholecystectomy is rare.A migrated endoclip can cause obstruction,serve as a nidus for stone formation,and cause cholangitis.While the exact pathogenesis is still unknown,it is probably related to improper clip application,subclinical bile leak,inflammation,and subsequent necrosis,allowing the clips to erode directly into the common bile duct.We present a case of endoclip migrating into the common bile duct and duodenum,resulting in choledochoduodenal fistula after laparoscopic cholecystectomy and a successful reconstruction of the biliary tract by a hepaticojejunostomy with a Roux-en-Y procedure.This case shows that surgical endoclips can penetrate into the intact bile duct wall through serial maceration,and it is believed that careful application of clips may be the only way to prevent their migration after laparoscopic cholecystectomy.
文摘Duodenal fistula refers to the pathological channel formed between the duodenum and the hollow viscera of the human body.If it is connected to a single cavity organ,it is a simple duodenal fistula.If it is connected to≥2 and the hollow viscera are connected,it is a complicated internal duodenal fistula,but simple ones are more common.Once a duodenal fistula develops,it establishes a pathological communication between duodenal contents and related organs,resulting in compromised organ function,infections,malnutrition,bleeding,and other detrimental effects.A patient with choledocholithiasis and choledochoduodenal fistula was treated in our hospital.She underwent laparoscopic left hemi-hepatectomy+laparoscopic choledochojejunostomy and was discharged 4 days after surgery.
