Residual or recurrent stones in the common bile duct can pose a diffic
ult diagnostic problem in the symptomatic postcholecystectomy patient,
Although incrustation of unabsorbed suture material is the most impor
tant cause of stone recurrence in the common bile duct after surgery,
hemostatic clips may also (though rarely) provide a nucleus for stone
formation, We present two cases in which this occurred, Careful attent
ion to the position and orientation of surgical clips on serial postop
erative film studies can be most helpful in diagnosing this rare condi
tion.