Bile leakage resulting from clip displacement of the cystic duct stump - Apotential pitfall of laparoscopic cholecystectomy

We present the case of a patient who underwent successful endoscopic nasobi liary drainage (ENBD) for bile leakage resulting from clip displacement of the cystic duct stump sustained during a laparoscopic cholecystectomy (LC), This 69-year-old man was admitted with symptomatic cholecystolithiasis. Af ter LC was performed, intraoperative cholangiography (IOC) revealed no abno rmal findings, However, postoperatively, bilious material began to appear f rom the intraabdominal drain. Subsequent endoscopic retrograde cholangiopan creatography (ERCP) showed bile leakage from the end of the cystic duct stu mp. ENBD was performed. Cholangiography using the ENBD tube 14 days later f ailed to show a bile leak. The ENBD was subsequently removed. The patient i mproved rapidly with no complaints. Bile leakage due to clip displacement f rom the cystic duct stump is a potential pitfall of LC, especially if IOC i s normal. We recommend careful cystic duct ligation, combined with the use of superior quality ligation clips, to prevent this complication. ENBD is a useful technique to prevent bile leakage after this complication.