Cholecystectomy clips are small surgical fasteners used during gallbladder removal to seal off the cystic duct and cystic artery before the gallbladder is detached. They work like tiny clamps, pinching these tubes shut so bile and blood can’t leak into the abdomen after surgery. Most people who’ve had their gallbladder removed have two or more of these clips inside them permanently.
What the Clips Do During Surgery
During a laparoscopic cholecystectomy (the most common type of gallbladder removal), the surgeon needs to disconnect the gallbladder from two structures: the cystic duct, which carries bile from the gallbladder to the common bile duct, and the cystic artery, which supplies blood to the gallbladder. Before cutting either one, the surgeon places clips on both sides of the planned cut. The clips on the body’s side stay in place permanently to keep the stump sealed. The clips on the gallbladder side come out with the removed organ.
This means most patients end up with at least two to four clips left inside: typically two on the cystic duct stump and one or two on the cystic artery stump. The clips are tiny, usually just a few millimeters long.
Materials: Titanium vs. Polymer
The two main types are metal clips and polymer clips. Titanium metal clips have been the standard choice for decades and are supplied by manufacturers including Medtronic, Ethicon, and Johnson & Johnson. They’re lightweight, biocompatible, and designed to stay in place indefinitely without corroding or causing a reaction in surrounding tissue.
Non-absorbable polymer clips, such as the Hem-o-Lock clip made by Teleflex Medical, have grown in popularity as an alternative. These plastic clips have a locking mechanism that snaps shut around the tissue, which some surgeons prefer because the lock makes the clip less likely to slip off. Both types are meant to remain in the body permanently. Absorbable clips that dissolve over time do exist, but they are far less commonly used.
Do They Show Up on Scans?
Titanium clips are visible on X-rays and CT scans as small bright spots near where the gallbladder used to sit. This is completely normal, and radiologists are accustomed to seeing them. If you have imaging done for an unrelated reason, the report will often note “surgical clips in the gallbladder fossa” as an incidental finding.
On MRI scans, metal clips can create artifacts, areas of distortion that obscure the image nearby. In some MRI sequences, the clips are nearly invisible and cause minimal interference. In others, particularly gradient echo sequences, the same clips can severely distort the image and make certain slices unreadable. Radiologists can work around this by choosing specific scan settings that reduce the effect. Polymer clips produce far less interference on MRI because they contain no metal.
MRI Safety and Airport Detectors
A common worry after surgery is whether these clips are safe in an MRI machine. Titanium is not magnetic in the way iron or steel is, so standard titanium surgical clips are generally considered MRI-compatible. Your surgical team or the MRI facility can verify the specific clip type used if there’s any concern.
As for airport security, surgical ligation clips are far too small to trigger metal detectors. Testing by researchers at the Royal College of Surgeons of England found that ligation clips and surgical staples failed to set off either archway or handheld detectors, even when present in multiple quantities. You won’t need to carry a medical card or explain anything at the airport.
Rare Complications
For the vast majority of people, cholecystectomy clips cause no problems whatsoever. They sit quietly in place for the rest of your life without any symptoms. In rare cases, though, a clip can migrate, meaning it shifts from its original position. A migrated clip can end up in the common bile duct, where it may act as a seed for a gallstone to form around, or it can erode into nearby structures. This complication has been reported with both titanium and polymer clips, though it remains uncommon.
Symptoms of a migrated clip typically resemble those of a bile duct stone: upper abdominal pain, jaundice (yellowing of the skin or eyes), or recurring episodes of pain after eating. If a clip does migrate into the bile duct, it can usually be retrieved with an endoscopic procedure rather than another surgery. Clip dislodgement shortly after surgery, while also rare, can cause bile leaks or bleeding, which would typically show up within the first few days of recovery.
Alternatives to Clips
Clips aren’t the only way to seal the cystic duct and artery. Some surgeons use ultrasonic cutting devices (often called harmonic scalpels) that seal tissue with high-frequency vibration, bipolar vessel sealers that use electrical energy, or old-fashioned suture ties and loops. These “clipless” techniques eliminate the possibility of clip migration entirely. However, they tend to be more expensive or require specialized equipment, and studies show comparable surgery times and safety profiles across all methods. The choice often comes down to surgeon preference and what’s available at the hospital.