ABSTRACT An 84‐year‐old woman with a history of laparoscopic cholecystectomy for gallbladder stone disease 6 years earlier presented to our outpatient clinic. She was referred to gastroenterology for a thorough examination after blood tests showed liver dysfunction. An abdominal non‐contrast computed tomography scan showed a hyperdensity area in the common bile duct with a suspected metallic component, and we diagnosed a clip‐stone complex caused by a migrated clip. Laparoscopic cholecystectomy has become the standard of care for cholecystolithiasis, and as the number of operations increases, it is important to keep post‐cholecystectomy clip migration in mind as a late postoperative complication. We decided to perform endoscopic retrograde cholangiography to remove the complex stones, and performed a balloon catheter stone removal procedure with endoscopic papillary large balloon dilation (EPLBD). There have been reports of emergency surgery due to stone interference between the clip and catheter when a basket catheter was used to remove stones. We argue that balloon catheter stone removal in combination with EPLBD should be considered for clip‐stone complexes.
Yamada et al. (Wed,) studied this question.