Table 1. Findings of the two large reviews and latest literature search.
Chong et al (2010) [5] | Pang et al (2019) [6] | Latest review | |
Number cases (period) | N = 69 (1978-2007) | N = 64 (1997-2017) | N= 53 (2018-2021) |
Gender | |||
Female | 42 (60.9%) | 35 (54.6%) | 26 (49.1%) |
Male | 26 (37.7%) | 26 (40.6%) | 26 (49.1%) |
Not stated | 1 (1.4%) | 3 (4.7%) | 1 (1.8%) |
Median age (yrs) | 60 (31-88) | 59.75 (31-93) | 65 (35 - 90) |
Initial operation | |||
LC | 47 (68.1%) | 43 (67.1%) | 37 (69.8%) |
LCBD | Not stated | 15 (23.4%) | 11 (20.8%) |
OC | 25 (36.2%) | 4 (6.2%) | 4 (7.5%) |
OC+OLT | 1 (2.1%) | 1 (1.6%) | 0 (0%) |
Not stated | Not stated | 1 (1.6%) | 1 (1.9%) |
Duration from surgery to presentation | Median: 26 months | Median: 24 months | Median: 49 months |
Mean: not reported | Mean: 55.4 months | Mean: 86.3 months | |
Range: 11 days to 20 yrs | Range 1 day to 20 years | Range: 1 month to 35 yrs | |
Symptoms reported | |||
Pain | 58 (84.1%) | 46 (71.8%) | 41 (77.4%) |
Jaundice | 53 (76.8%) | 30 (46.9%) | 25 (47.2%) |
Fever | 22 (31.9%) | 19 (29.7%) | 21 (39.6%) |
Nausea/vomiting | 18 (26.1%) | 18 (28.1%) | 7 (13.2%) |
Chills | Not stated | 5 (7.8%) | 1 (1.9%) |
Asymptomatic | Not stated | 12 (18.8%) | 9 (17.0%) |
Admitting diagnosis | |||
Obstructive jaundice | 26 (37.7%) | Not stated | 13 (24.5%) |
Cholangitis | 19 (27.5%) | Not stated | 18 (33.9%) |
Biliary colic | 13 (18.8%) | Not stated | 12 (22.6%) |
Acute pancreatitis | 6 (8.7%) | Not stated | 1 (1.9%) |
Incidental finding | 3 (4.3%) | Not stated | 9 (17.0%) |
Abnormal liver profiles only | 2 (2.8%) | Not stated | 1 (1.9%) |
Migrated lip on radiography | 1 (1.4%) | Not stated | Not stated |
Location of clip migrations | |||
Common bile duct | 69 (100%) | 49 (76.6%) | 53 (100%) |
Duodenum | 0 (0%) | 4 (6.3%) | 0 (0%) |
T-tube | 0 (0%) | 10 (15.6%) | 0 (0%) |
Gallbladder remnant | 0 (0%) | 1 (1.6%) | 0 (0%) |
Median number of migrated clips | 1 (range 1- 6) | 1 (range 1-4) | 1 (range 1-6) |
Type of clips | |||
Metal | Mostly metal | Not reported | 35 (66.0%) |
Absorbable | Not reported | Not reported | 3 (5.7%) |
Hem-o-Lok | Not reported | Not reported | 15 (28.3%) |
Management | |||
ERCP (Successful clearance) | 53 (77.0%) | 35 (54.7%) | 37 (69.8%) |
ERCP (failed clearance needing surgery) | Not reported | 6 (9.4%) | 2 (3.8%) |
Surgery | 14 (20.2%) | 13 (21.3%) | 7 (13.2%) |
Choledochoscopic clearance | 14 (20.2%) | 12 (18.8%) | 1 (1.9%) |
Others | 1 (1.4%) | 4 (6.4%) | 3 (5.7%) |