{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:06:47Z","timestamp":1780463207193,"version":"3.54.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018556","name":"Science and Technology Program of Suzhou","doi-asserted-by":"crossref","award":["TC2024JCYL23"],"award-info":[{"award-number":["TC2024JCYL23"]}],"id":[{"id":"10.13039\/501100018556","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100018556","name":"Science and Technology Program of Suzhou","doi-asserted-by":"crossref","award":["ZDXM2025026"],"award-info":[{"award-number":["ZDXM2025026"]}],"id":[{"id":"10.13039\/501100018556","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100018556","name":"Science and Technology Program of Suzhou","doi-asserted-by":"crossref","award":["SYW2025037"],"award-info":[{"award-number":["SYW2025037"]}],"id":[{"id":"10.13039\/501100018556","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Clip migration into the common bile duct (CBD) represents a rare yet severe complication after laparoscopic biliary surgery. Herein, we report a case of a 75-year-old male patient who previously received simultaneous laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) with T-tube drainage. The patient was admitted with upper abdominal pain and jaundice. Elevated inflammatory indicators and liver function enzymes indicated biliary obstruction complicated by cholangitis. Abdominal computed tomography (CT) revealed CBD stones and two intraductal high-density foreign bodies, highly suggestive of migrated surgical clips. After empirical antibiotic administration, the patient underwent emergent reoperative LCBDE and T-tube reinsertion on hospital day 2. Intraoperative exploration confirmed complete clearance of biliary stones, with one Hem-o-lok clip and one titanium clip embedded in the stones. The patient had an uneventful postoperative course and was discharged with a favorable prognosis. This case report combined with literature review further clarifies the etiological characteristics of clip migration, and provides practical references for the early prevention and individualized management of such rare biliary complications.<\/jats:p>","DOI":"10.3389\/fmed.2026.1869401","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:49:46Z","timestamp":1780462186000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Clip migration induced recurrent choledocholithiasis after laparoscopic common bile duct exploration"],"prefix":"10.3389","volume":"13","author":[{"given":"Bin","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of General Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Taicang Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Taicang Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Taicang Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danfeng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Taicang Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e2019.53","DOI":"10.4293\/JSLS.2019.00053","article-title":"Clip as nidus for choledocholithiasis after cholecystectomy\u2014literature review","volume":"24","author":"Ng","year":"2020","journal-title":"J Soc Laparoendosc Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2786","DOI":"10.1007\/s00464-021-08563-2","article-title":"Low insertion of cystic duct increases risk for common bile duct stone recurrence","volume":"36","author":"Choi","year":"2022","journal-title":"Surg Endosc"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-025-09622-7","article-title":"Multi-center study of the association between serum lipid levels and recurrent common bile duct stone after endoscopic retrograde cholangiopancreatography with propensity score matching analysis","author":"Wang","year":"2025","journal-title":"Dig Dis Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1080\/17474124.2023.2242784","article-title":"Risk factors for recurrent common bile duct stones: a systematic review and meta-analysis","volume":"17","author":"Wen","year":"2023","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e70280","DOI":"10.1002\/deo2.70280","article-title":"Clip-centered common bile duct stones managed by endoscopic sphincterotomy plus endoscopic papillary large balloon dilation years after cholecystectomy","volume":"6","author":"Fukuba","year":"2026","journal-title":"DEN Open"},{"key":"ref6","first-page":"V10210778","article-title":"Acute cholangitis due to metal clips in the ductus choledochus after laparoscopic cholecystectomy","volume":"184","author":"Snitkj\u00e6r","year":"2022","journal-title":"Ugeskr Laeger"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3000605231190766","DOI":"10.1177\/03000605231190766","article-title":"Clip migration complicated by choledocholithiasis after laparoscopic biliary surgery: a report of four cases","volume":"51","author":"Wu","year":"2023","journal-title":"J Int Med Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"6548","DOI":"10.12998\/wjcc.v10.i19.6548","article-title":"Hem-o-lok clip migration to the common bile duct after laparoscopic common bile duct exploration: a case report","volume":"10","author":"Liu","year":"2022","journal-title":"World J Clin Cases"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int J Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2809","DOI":"10.1007\/s00464-021-08568-x","article-title":"Reinterventions following laparoscopic cholecystectomy and bile duct exploration. 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