Hem-o-lok clip migration to duodenal bulb post-cholecystectomy:A case report  

作　　者：Hong-Yan Liu Ai-Hong Yin Zhi Wei 

机构地区：[1]Department of Gastroenterology,Shandong Second Provincial General Hospital,Jinan 250022,Shandong Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第5期1461-1466,共6页世界胃肠外科杂志（英文版）（电子版）

摘　　要：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.

关 键 词：Hem-o-lok clip MIGRATION DUODENUM Laparoscopic cholecystectomy Laparoscopic common bile duct exploration Case report 

分 类 号：R656[医药卫生—外科学]