INTRODUCTION: Mirizzi syndrome (MS) is an unusual complication of gallstone disease. The majority of cases are not identified pre-operatively, despite advances in imaging techniques. MATERIALS AND METHODS: Eighteen cases of MS were treated between January 1997 and April 2002. The clinical presentation, modes of investigation, surgical management and outcome are retrospectively reviewed. RESULTS: There were 13 female and 5 male patients, with a mean age of 60 years. Seven patients presented with the classical Charcot's triad. Ultrasonography (US) was the first imaging investigation in 13 patients and computerised tomography (CT) in the other five cases. Eleven patients had a successful endoscopic retrograde cholangio-pancreatography (ERCP) carried out. Diagnosis of MS was arrived at in seven patients following pre-operative imagings. Overall, 11 patients had Type 1 and seven patients had Type 2 MS. In the group with Type 1 MS, nine patients underwent open cholecystectomy, of whom six had concomitant common bile duct (CBD) exploration for stones and one patient with biliary stenosis had a hepaticojejunostomy bypass. Laparoscopic cholecystectomy was attempted in two patients, with successful completion in one case. In the group with Type 2 MS, four fistulas were closed surgically, the other three had biliary bypass procedures. CONCLUSION: Mirizzi syndrome is an unusual condition that poses diagnostic and operative challenges to the surgeon. With a judicious approach during dissection and early recognition of its presence, bile duct injury can be avoided. Good outcome can be achieved with an appropriate surgical procedure.
INTRODUCTION:Mirizzi syndrome (MS) is an unusual complication of gallstone disease. The majority of cases are not identified pre-operatively, despite advances in imaging techniques. MATERIALS AND METHODS: Eighteen cases of MS were treated between January 1997 and April 2002. The clinical presentation, modes of investigation, surgical management and outcome are retrospectively reviewed. RESULTS: There were 13 female and 5 male patients, with a mean age of 60 years. Seven patients presented with the classical Charcot's triad. Ultrasonography (US) was the first imaging investigation in 13 patients and computerised tomography (CT) in the other five cases. Eleven patients had a successful endoscopic retrograde cholangio-pancreatography (ERCP) carried out. Diagnosis of MS was arrived at in seven patients following pre-operative imagings. Overall, 11 patients had Type 1 and seven patients had Type 2 MS. In the group with Type 1 MS, nine patients underwent open cholecystectomy, of whom six had concomitant common bile duct (CBD) exploration for stones and one patient with biliary stenosis had a hepaticojejunostomy bypass. Laparoscopic cholecystectomy was attempted in two patients, with successful completion in one case. In the group with Type 2 MS, four fistulas were closed surgically, the other three had biliary bypass procedures. CONCLUSION:Mirizzi syndrome is an unusual condition that poses diagnostic and operative challenges to the surgeon. With a judicious approach during dissection and early recognition of its presence, bile duct injury can be avoided. Good outcome can be achieved with an appropriate surgical procedure.
Authors: Alan Isaac Valderrama-Treviño; Juan José Granados-Romero; Mariana Espejel-Deloiza; Jonathan Chernitzky-Camaño; Baltazar Barrera Mera; Aranza Guadalupe Estrada-Mata; Jesús Carlos Ceballos-Villalva; Jonathan Acuña Campos; Rubén Argüero-Sánchez Journal: Hepatobiliary Surg Nutr Date: 2017-06 Impact factor: 7.293
Authors: Mohammed H A Al-Akeely; Mohammed K Alam; Hayan Abdulrahman Bismar; Kamran Khalid; Ibrahim Al-Teimi; Nasser Faleh Al-Dossary Journal: World J Surg Date: 2005-12 Impact factor: 3.352
Authors: K Altaf Hussain Talpur; Arshad Mahmood Malik; Amir Iqbal Memon; Jawed Naeem Qureshi; Ahmed Khan Sangrasi; Abdul Aziz Laghari Journal: Pak J Med Sci Date: 2013-05 Impact factor: 1.088