Can surgical clips cause problems years later? Unveiling the long-term risks

September 30, 2025 •

4 min read

While surgical clips are designed to be a permanent and inert part of the body, medical literature includes case reports of complications occurring decades later. This article explores the various ways can surgical clips cause problems years later and what patients need to know.

Quick Summary

Surgical clips are generally safe and inert, but rare, long-term complications can occur, such as clip migration, allergic reactions, and pain. These issues can surface many years after the initial procedure, particularly in specific surgical contexts.

Key Points

Rare but Possible: Most surgical clips are inert, but some patients experience rare, delayed complications like migration or allergic reactions, sometimes decades after surgery.
Migration Causes Obstruction: The most documented long-term problem is clip migration, where a clip moves and causes a blockage, often seen in the bile duct following a cholecystectomy.
Allergies Are a Concern: Systemic or local hypersensitivity reactions to the metal in clips, such as nickel or titanium, can cause chronic, non-specific symptoms like pain, rashes, and fatigue.
Diagnosis is Key: Persistent, unexplained symptoms after surgery warrant a medical evaluation using imaging like CT or MRCP to determine if a clip is the cause.
Treatment is Available: If a clip causes a problem, treatment options exist, including minimally invasive endoscopic procedures (ERCP) for migrated clips or surgical removal for other complications.
Know Your Implant: Informing future healthcare providers of your surgical history and any implanted clips is crucial, especially when undergoing imaging like an MRI.

What are Surgical Clips?

Surgical clips, also known as ligating clips, are small, clamp-like devices used during various surgical procedures to ligate (tie off) blood vessels, ducts, and other tubular structures. They are a quick and reliable alternative to traditional suturing, particularly in minimally invasive or laparoscopic surgery, where space is limited. The clips are typically made of materials designed to be biocompatible, meaning the body does not react adversely to them over time.

Common Surgical Procedures Using Clips

One of the most common applications for surgical clips is during a laparoscopic cholecystectomy, or gallbladder removal. During this procedure, titanium clips are often used to close off the cystic duct and cystic artery. Other procedures that may utilize surgical clips include hysterectomies, prostatectomies, and other abdominal surgeries. For most patients, these clips remain in place for life without issue, becoming encapsulated by surrounding tissue.

Potential Problems Years Later: Unveiling the Risks

While most surgical clips remain benign, a small percentage of patients experience rare but serious complications that can manifest years after the initial surgery. The reasons for these delayed issues are not fully understood but are believed to be related to chronic inflammation or mechanical erosion over time.

The Phenomenon of Clip Migration

Clip migration is a well-documented but rare complication where a surgical clip dislodges and moves from its original position. In laparoscopic cholecystectomies, clips can migrate into the common bile duct, where they can act as a nucleus for the formation of gallstones (choledocholithiasis). In some cases, this has been reported to occur more than 20 to 30 years after the initial surgery.

Symptoms of clip migration often mimic gallstone-related problems, including:

Right upper quadrant abdominal pain
Jaundice (yellowing of the skin and eyes)
Fever and chills (indicating cholangitis or infection)
Pancreatitis due to obstruction

Beyond the biliary system, clips have been reported to migrate to other areas, including the urinary tract, bladder, or intestines, leading to other complications like obstruction or inflammation.

Metal Allergies and Hypersensitivity Reactions

Though surgical clip materials like titanium are chosen for their biocompatibility, some individuals may have a pre-existing or developing hypersensitivity. Hypersensitivity reactions can be triggered by the slow release of metal ions from the clips over time. A study in Cureus describes a patient with a nickel allergy who experienced chronic systemic symptoms years after receiving stainless steel clips following a cholecystectomy.

Symptoms of metal hypersensitivity can be wide-ranging and non-specific, including:

Skin rashes, urticaria (hives), or chronic dermatitis
Fatigue and lethargy
Joint and muscle aches (myalgia)
Unexplained chronic pain at or near the surgical site
Mental fogginess

Other Rare Long-Term Issues

In addition to migration and allergy, other rare complications can arise. A foreign body reaction, a specific type of inflammatory response to an implanted object, can cause local swelling, pain, or discomfort. Cases of nerve impingement from a misplaced clip have also been reported, resulting in chronic localized pain. While extremely rare, issues like mechanical failure or corrosion of the clip are also theoretical possibilities, though modern biocompatible materials are designed to resist this.

Comparison of Common Surgical Clip Materials


Feature	Titanium Clips	Stainless Steel Clips	Absorbable Polymer Clips
Biocompatibility	Excellent; highly inert and corrosion-resistant	Good, but depends on the alloy. Some contain nickel, a common allergen	Excellent; designed to be gradually absorbed by the body over time
MRI Compatibility	Generally safe and MRI-compatible, but can cause mild imaging artifacts	Most are considered safe for MRI, but can also cause artifacts, especially older clips	No impact on MRI, as they dissolve over time
Risk of Allergy	Very low, as titanium allergies are rare	Higher, especially in individuals with known nickel allergies	Essentially zero risk of metal-related allergy
Permanence	Permanent; remains in the body indefinitely	Permanent; remains in the body indefinitely	Not permanent; gradually resorbed by the body

Diagnosis and Management

If you experience persistent or new symptoms years after a surgery involving clips, it is crucial to communicate your full surgical history to your healthcare provider. Diagnosis often requires a combination of clinical evaluation and imaging studies. These may include:

Ultrasound: Can detect a migrated clip or gallstones in the bile duct.
Computed Tomography (CT) scan: Useful for visualizing metallic clips and identifying obstructions.
Magnetic Resonance Cholangiopancreatography (MRCP): A specialized MRI that can provide detailed images of the biliary and pancreatic ducts.

Management depends on the specific issue. For migrated clips causing obstruction, a minimally invasive procedure called endoscopic retrograde cholangiopancreatography (ERCP) is often the first-line treatment, with a high success rate. In cases of allergic reaction or other complex issues, surgical removal of the clips may be considered.

Conclusion

While surgical clips are a mainstay in modern surgery and remain harmless for the vast majority of patients, they are not without their potential for very rare, long-term complications. Understanding the risks of clip migration and metal hypersensitivity can help patients and physicians recognize and address problems years after the initial procedure. The ability to identify these rare complications with advanced imaging and the availability of effective treatments, from endoscopy to surgical removal, mean that symptomatic patients can find relief. The decision to use surgical clips versus alternatives like sutures is constantly evolving with advancements in surgical techniques and patient-specific factors, such as metal allergies.

For more information on the safety of medical implants, consult resources from authoritative bodies like the National Institutes of Health.

Frequently Asked Questions

Surgical clips are most commonly made from inert, biocompatible materials such as titanium or stainless steel, which are intended to remain permanently in the body. Some clips are also made from absorbable polymers that dissolve over time.

While most clips never cause problems, and early issues are rare, some complications like migration or allergic reactions can develop years or even decades after the initial procedure. The time frame is highly variable.

Symptoms can be diverse and non-specific, including unexplained abdominal pain, jaundice, fever, skin rashes, or chronic fatigue. A thorough medical evaluation, often involving imaging, is necessary for an accurate diagnosis.

Yes, if a clip is confirmed to be causing a medical problem, it can often be removed. The procedure depends on its location, with endoscopic retrograde cholangiopancreatography (ERCP) used for migrated clips in the bile duct or surgery for other complications.

Modern surgical clips, particularly those made of non-ferrous materials like titanium, are generally safe for MRI scans. However, it is essential to inform the imaging technician of any implants, as some clips may cause imaging artifacts.

No, surgical clip migration is considered a very rare complication, with only a small number of reported cases relative to the large volume of procedures performed using clips.

Surgeons minimize risks by using the fewest clips necessary, ensuring accurate placement, and sometimes opting for non-metallic or absorbable options, especially if a metal allergy is suspected.