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Mirizzi syndrome: laparoscopic management by subtotal cholecystectomy

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Abstract

Background

The authors present their experience with laparoscopic subtotal cholecystectomy for the management of Mirizzi’s syndrome and their review of the literature.

Methods

Over a period of 24 months, five cases of Mirizzi’s syndrome were encountered, representing 1.5% of all the laparoscopic cholecystectomies performed in the authors’ unit. The sex ratio was 4 females to 1 male, and the mean age of the patients was 66 years. All underwent a subtotal cholecystectomy.

Results

All procedures were completed laparoscopically. Morbidities involved one case of biliary peritonitis and a one case of biliary leak requiring endoscopic stenting.

Conclusion

Mirizzi’s syndrome cannot always be anticipated on the basis of preoperative staging, and often is encountered during the procedure. The “anatomic scenario” of this condition should be suspected for patients presenting with conditions such as empyema or mucocoele when there is a likelihood of stone impaction in the infundibulum of the gallbladder. Subtotal cholecystectomy with secure intraperitoneal biliary drainage appears to be a safe option for these patients.

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References

  1. Becker CD, Grossholz M, Mentha G, de Peyer R, Terrier F (1997) MR cholangiopancreatography: technique, potential indications, and diagnostic features of benign, postoperative, and malignant conditions. Eur Radiol 7: 865–874

    Article  PubMed  CAS  Google Scholar 

  2. Behrend A, Cullen ML (1950) Cholecystocholedochal fistula, an unusual form of internal biliary fistula. Ann Surg 132: 297–303

    PubMed  CAS  Google Scholar 

  3. Choi BW, Kim MJ, Chung JJ, Chung JB, Yoo HS, Lee JT (2000) Radiological findings of Mirizzi Syndrome with emphasis on MRI. Yonsei Med J 41: 144–146

    PubMed  CAS  Google Scholar 

  4. Chowbey PK, Sharma A, Mann V, Khullar R, Baijal M, Vashistha A (2000) The management of Mirizzi syndrome in the laparoscopic era. Surg Laparosc Endosc Percutan Tech 10: 11–14

    Article  PubMed  CAS  Google Scholar 

  5. Csendes A, Diaz J, Burdiles P, Maluenda P, Nava O (1989) Mirizzi syndrome and cholecystobiliary fistula: a unifying classification. Br J Surg 76: 1139–1143

    PubMed  CAS  Google Scholar 

  6. Desai DC, Smink RD (1997) Mirizzi syndrome type II: is laparoscopic cholecystectomy justified? J Soc Laparosc Surg 1: 237–239

    CAS  Google Scholar 

  7. Dietrich KF (1963) Die Hepatikusstenose bei gallenblasenhals und Zystikussteinen (Mirizzi Syndrom). Bruns Beitr Klin Chir 206: 9–22

    CAS  Google Scholar 

  8. Doai K, Uchiyama K, Kuniyasu Y, Saisyo H (1998) MR cholangiopancreatography of Mirizzi syndrome and Lemmel syndrome. Nippon Rinsho. Jpn J Clin Med 56: 2933–2938

    CAS  Google Scholar 

  9. Hsu YB, Yu SC, Lee PH, Wei TC (1994) An uncommon cause of biliary obstruction (Mirizzi syndrome): report of five cases. J Formosan Med Assoc 93: 314–319

    PubMed  CAS  Google Scholar 

  10. Kehr H (1905) Die in meiner klinik geobte Technik der Gallenstein operationen miteinem Hinweis. Auf die Indikation und die Dauererfolge. Munchen: J. F. Lehmann’s Verlag 209–283

    Google Scholar 

  11. Kim PN, Outwater EK, Mitchell DG (1999) Mirizzi syndrome: evaluation by MRI imaging. Am J Gastroenterol 94: 2546–2550

    Article  PubMed  CAS  Google Scholar 

  12. Meng WCS, Kwok SPY, Kelly SB, Lau WY, Li AK (1995) Management of Mirizzi syndrome by laparoscopic cholecystectomy and laparoscopic ultrasonography. Br J Surg 82: 396

    PubMed  CAS  Google Scholar 

  13. Mirizzi PL (1948) Sindrome del conducto hepatico. J Int Chir 8: 731–777

    Google Scholar 

  14. Redaelli CA, Buchler MW, Schilling MK, Krahenbuhl L (1997) High coincidence of Mirzzi syndrome and gallbladder carcinoma. Surgery 121: 58–63

    Article  PubMed  CAS  Google Scholar 

  15. Ruge E (1908) Deitrage Zur Chinurgishen Anatonmie der grossen Gallenwage (Ductus hepaticus, choledochus und pancreaticus. Arch Clin Chir 78: 47

    Google Scholar 

  16. Sare M, Gurer S, Taskin V, Aladag M, Hilmioglu F, Gurel M (1998) Mirrizzi syndrome: choice of surgical procedure in the laparoscopic era. Surg Laparosc Endosc 8: 63–67

    Article  PubMed  CAS  Google Scholar 

  17. Schafer M, Schneiter R, Krahenbuhl L (2003) Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy. Surg Endosc 17: 1186–1190

    Article  PubMed  CAS  Google Scholar 

  18. Seitz U, Bapaye A, Bohnacker S, Navarrete C, Maydeo A, Soehendra N (1998) Advances in therapeutic endoscopic treatment of common bile duct stones. World J Surg 22: 1133–1144

    Article  PubMed  CAS  Google Scholar 

  19. Shah OJ, Dar MA, Wani MA, Wani NA (2001) Management of Mirizzi syndrome: a new surgical approach. Anz J Surg 71: 423–427

    Article  PubMed  CAS  Google Scholar 

  20. Tanaka N, Nobori M, Furuya T, Ueno T, Kimura H, Nagai M, Kanno T, Mizuta K, Asada M (1995) Evolution of Mirizzi syndrome with biliobiliary fistula. J Gastroenterol 30: 117–121

    Article  PubMed  CAS  Google Scholar 

  21. Tsuyuguchi T, Saisho H, Ishihara T, Yamaguchi T, Onuma EK (2000) Long-term follow-up after treatment of Mirizzi syndrome by peroral cholangiography. Gastrointest Endosc 52: 639–644

    Article  PubMed  CAS  Google Scholar 

  22. Vezakis A, Davides D, Birbas K, Ammori BJ, et al. (2000) Laparoscopic treatment of mirizzi syndrome. Surg Laparos Endosc Percutan Tech 10: 15–18

    Article  CAS  Google Scholar 

  23. Yip AWC, Chow WC, Chan J, Lam KH (1992) Mirizzi syndrome with cholecystocholedochal fistula: preoperative diagnosis and management. Surgery 111: 335–338

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Hospital Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, BN11 2HR, UK

    A. Rohatgi & K. K. Singh

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  1. A. Rohatgi
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  2. K. K. Singh
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Corresponding author

Correspondence to K. K. Singh.

Additional information

Presented in part at the Association of Endoscopic Surgeons of Great Britain and the Ireland Spring Meeting, 24 May 2002, and at the 18th World Congress of Digestive Surgery in Hong Kong, 8–11 December 2002

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Rohatgi, A., Singh, K.K. Mirizzi syndrome: laparoscopic management by subtotal cholecystectomy. Surg Endosc 20, 1477–1481 (2006). https://doi.org/10.1007/s00464-005-0623-6

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  • DOI: https://doi.org/10.1007/s00464-005-0623-6

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