Laparoscopic surgery in the treatment of Mirizzi's syndrome.

Mirizzi's syndrome is an unusual complication of cholelithiasis which results when an impacted cystic duct stone causes edema and compression of the adjacent common hepatic duct. The authors report the successful treatment of a patient with this syndrome by laparoscopic means. A flexible 5.0 mm choledochoscope was inserted under laparoscopic guidance into the dilated proximal cystic duct and the impacted stone was extracted. Though still a technically demanding procedure, the authors feel that under certain conditions, laparoscopic surgery may represent the preferred initial approach to patients with Mirizzi's syndrome.