Mirizzi syndrome grades III and IV: surgical treatment

Reverdito, Ronald; Moricz, André de; Campos, Tércio De; Júnior, Adhemar Monteiro Pacheco; Silva, Rodrigo Altenfelder

doi:10.1590/0100-69912016004005

Cited by 13 publications

(6 citation statements)

References 17 publications

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“…[ 21 ] Existing literature confirms a diagnostic accuracy of 29%, with a sensitivity between 8.3% and 27%. [ 8 , 17 , 18 , 26 ] In one study involving 198 patients, the sensitivity of ultrasound for Mirizzi Syndrome was as high as 77.8%. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

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Current trends in the management of Mirizzi Syndrome

et al. 2018

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Mirizzi Syndrome is a rare and challenging clinical entity to manage. However, recent advances in technology have provided surgeons with new options for more effective diagnosis and treatment of this condition. This paper reviews these new diagnostic modalities and treatment approaches for the management of Mirizzi Syndrome.An online search language was performed using PubMed and Web of Science for literature published in English between 2012 and 2017 using the search terms “Mirizzi Syndrome” and “Mirizzi.” In total, 16 case series and 11 case reports were identified and analyzed.The most frequently used diagnostic modalities were ultrasound, computed tomography (CT); magnetic resonance cholangiopancreaticography (MRCP); endoscopic retrograde cholangiopancreaticography (ERCP). A combination of ≥2 diagnostic modalities was frequently used to detect Mirizzi Syndrome. Literature shows that the specific type of Mirizzi Syndrome determined the type of treatment chosen. Open surgery was the preferred option, although there are documented cases of the use of minimally-invasive techniques, even in advanced cases. Laparoscopic, endoscopic or robot-assisted surgery, used individually or in combination with lithotripsy, were all associated with a favorable outcome.As yet, there are no internationally-accepted guidelines for the management of Mirizzi Syndrome. Laparotomy is the preferred surgical technique of choice, although an increasing number of surgeons are beginning to opt for minimally-invasive techniques. The number of papers in the existing literature describing diagnostic and treatment procedures is relatively small at present, thus making it difficult to reasonably propose an evidence-based standard of care for Mirizzi Syndrome.

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Section: Discussionmentioning

confidence: 99%

“…However, some authors support the view that the presence of a fistula with a diameter wider than two-thirds of the CBD (Type III and Type IV) should warrant RYHJ. [ 16 – 18 , 22 ] The safest approach to manage Mirizzi Syndrome Type V is always laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Current trends in the management of Mirizzi Syndrome

et al. 2018

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“…Abdominal ultrasound, which has a sensitivity of 8.3-27%, generally shows cholelithiasis with impacted gallstone in Hartmann's pouch or in the gallbladder infundibulum, contracted gallbladder and biliary ducts dilation. 16,17 Abdominal CT does not have specific radiological features for MS, but this technique can be very effective in detecting the cause and location of biliary obstruction. 18 It also may either exclude neoplastic lesions or suggest them in the presence of lymph node enlargement, hepatic infiltration or metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…18 It also may either exclude neoplastic lesions or suggest them in the presence of lymph node enlargement, hepatic infiltration or metastasis. 16 MRCP is a valuable method to study the biliary tract, with an accuracy of 50% for the diagnosis of MS. 16 Using image weighted in T2 it is possible to differentiate between inflammatory (characteristic of MS) and neoplastic process, which may not be possible using ultrasound or CT. 18,19 ERCP, modality of image exam with the most sensitivity, has an accuracy of 50-100%, performing the diagnosis of cholecystobiliary fistula and, when associated with sphincterotomy, allows for biliary decompression and prosthesis placement in patients with obstructive jaundice and cholangitis. 16 In the case reported, the patient underwent ERCP, hence a biliary tract study was already performed, thus MRCP was found unnecessary.…”

Section: Discussionmentioning

confidence: 99%

Mirizzi syndrome mimicking cholangiocarcinoma. Case report

Mitsumoto¹,

Silva²,

Ribeiro³

et al. 2020

Acta gastroenterol. latinoam.

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Mirizzi syndrome (MS) is a rare condition whose clinical presentation is unspecific, with obstructive jaundice being the most common form. MS is often not recognized at initial presentation, which can result in morbidity and biliary injury. Preoperative diagnosis is uncommon and over 50% of patients with MS are diagnosed during surgery. There are no clinical features to distinguish MS from cholangiocarcinoma, except that patients with cholangiocarcinoma are on average ten years older than patients with MS. We report the case of a 51-year-old female patient who presented with jaundice and weight loss. Following investigation with laboratory and imaging exams, the initial diagnosis was Bismuth II cholangiocarcinoma. The patient underwent surgical intervention, and anatomopathological examination of the specimen showed the correct diagnosis to be MS. Despite the rarity of its incidence, physicians must keep MS in mind as a possible differential diagnosis for cholangiocarcinoma and vice-versa. We discuss this case in the context of a brief review of the literature on Mirizzi syndrome mimicking cholangiocarcinoma.

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“…Hoje em dia é considerado como um dos maiores fenômenos socioculturais contemporâneos (DEL PRIORE;MELO, 2009;GALATTI et al, 2014;REVERDITO;SCAGLIA, 2000), proporcionando que diferentes personagens se envolvam com sua prática e/ou apreciação, atribuindo diferentes sentidos à esse envolvimento.…”

Section: Introductionunclassified

Possibilidades pedagógicas para o ensino do tênis na escola

2018

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Este artigo, de caráter ensaístico-propositivo, tem o intuito de apontar alguns aspectos para a sistematização do ensino dos elementos técnicos e táticos do tênis nas escolas segundo as abordagens atuais da Pedagogia do Esporte. Inicialmente são apresentados os elementos de desempenho do tênis, em especial aqueles enfatizados nas fases iniciais de ensino: a técnica (habilidade técnica) e a tática (tática individual). Num segundo momento são apresentadas as formas de ensino destes elementos segundo as abordagens atuais da Pedagogia do Esporte. Desse modo, nesta perspectiva de ensino, são apresentadas propostas para ensinar alunos com poucas habilidades, ao mesmo tempo em que estas são desenvolvidas durante os jogos táticos, envolvendo também as habilidades técnicas básicas da fase de iniciação e as formas de adaptação dos materiais durante a fase inicial de ensino em um contexto educacional com elevado número de crianças.

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Mirizzi syndrome grades III and IV: surgical treatment

Abstract: de incidência baixa e de diagnóstico pré-operatório em apenas metade dos casos, a SM em graus avançados tem na anastomose biliodigestiva sua melhor conduta, porém não isenta de morbimortalidade.

Cited by 13 publications

References 17 publications

Current trends in the management of Mirizzi Syndrome

Current trends in the management of Mirizzi Syndrome

Mirizzi syndrome mimicking cholangiocarcinoma. Case report

Possibilidades pedagógicas para o ensino do tênis na escola

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