![]() ![]() Sharma, Ajay Behari, Anu Sikora, Sadiq S Kumar, Ashok Saxena, Rajan Kapoor, Vinay K Post-cholecystectomy biliary strictures: not always benign. The magnesium alloy clip revealed much fewer metallic artifacts in CT than the conventional titanium clip. The novel magnesium alloy clip demonstrated sufficient sealing capability for the cystic duct and proper biodegradability in canine models. There were no postoperative complications and no elevation of constituent elements such as magnesium, calcium, and zinc during the observation period in both groups. The magnesium alloy clip formed much fewer artifacts than the titanium clip, and it was almost absorbed at 6 months postoperative. We also evaluated their effect on the living body by blood biochemistry data. The animals were killed at the end of the observation period, and the clips were removed to evaluate their biodegradability. ![]() The chronologic change of clips and artifact formation were compared at 1, 4, 12, 18, and 24 weeks postoperative by computed tomography. We performed cholecystectomy and ligated the cystic duct by magnesium alloy or titanium clips. ![]() ![]() In this study, we verified the safety and tolerability of this clip for use in canine cholecystectomy. We developed a biodegradable magnesium-zinc-calcium alloy clip with good biologic compatibility and enough clamping capability as an operative clip. Although biodegradable magnesium instruments have been developed in other fields, the physical properties necessary for operative clips differ from those of other instruments. They remain in the body permanently and form metallic artifacts in computed tomography images, which impair accurate diagnosis. Operative clips used to ligate vessels in abdominal operation usually are made of titanium. Yoshida, Toshihiko Fukumoto, Takumi Urade, Takeshi Kido, Masahiro Toyama, Hirochika Asari, Sadaki Ajiki, Tetsuo Ikeo, Naoko Mukai, Toshiji Ku, Yonson Two months later, we repeated the EGD, which revealed that the clip was no longer present, and the duodenum was covered with normal mucosa surrounding the scar.ĭevelopment of a new biodegradable operative clip made of a magnesium alloy: Evaluation of its safety and tolerability for canine cholecystectomy. The patient was treated with an oral proton pump inhibitor to prevent extensive duodenal mucosal injury. Therefore, we decided not to attempt to remove the clip. On clinical examination of the patient, no major abnormalities or physical findings were noted. We appreciated that endoscopic clip removal would be difficult because of the presence of severe adhesions and inflammation of the duodenal bulb. In the EGD, duodenal erosions and edema were observed around the clip. Thirteen months after Lap-C, the patient underwent a screening esophagogastroduodenoscopy (EGD), which demonstrated clip appearance at the inferior wall of the first part of the duodenum. Due to the presence of extensive adhesions of the cystic duct and surrounding tissue, the surgeons had difficulty in debriding the area. During surgery, Hem-o-Lok clips were used to control the cystic duct and the cystic artery. The patient was a 66-year-old woman who had undergone laparoscopic cholecystectomy (Lap-C) secondary to chronic cholecystitis status post endoscopic choledocholithotomy 13 months previously. Soga, Koichi Kassai, Kyoichi Itani, Kenji All rights reserved.ĭuodenal Ulcer Induced by Hem-o-Lok clip after Reduced Port Laparoscopic Cholecystectomy. We present the case of a patient who presented with signs and symptoms of cholangitis due to clip migration one year after laparoscopic cholecystectomy endoscopic retrograde cholangiopancreatography and biliary tract stent placement resolved the problem. The migration of a clip to the common bile duct after cholecystectomy is an uncommon, usually late, complication that can lead to diverse complications like stone formation, stenosis, and obstruction in the bile duct. īaldomà España, M Pernas Canadell, J C González Ceballos, S ![]()
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