Manejo cirúrgico da síndrome de Mirizzi

Fonseca-Neto, Olival Cirilo Lucena da; Pedrosa, Maria das Graças Lapenda; Miranda, Antonio Lopes de

doi:10.1590/s0102-67202008000200002

Cited by 2 publications

(2 citation statements)

References 13 publications

(11 reference statements)

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“…It is the complication of long standing cholecistolithiasis. [6,7] In MS with CEF, the calculus usually migrate through the main biliary tract to duodenum which then lead to luminal obstruction of the terminal ilem with an incidence of 0.05 to 2.7%. [8] It is difficult to diagnose MS because of the absence of pathognomonic signs and symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Surgical outcomes of mirizzi syndrome: a single institution's experience of 34 cases

Öter¹

2017

Laparosc Endosc Surg Sci

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Introduction: Mirizzi syndrome (MS) is a rare complication of cholelithiasis and surgery is the treatment of choice. It usually requires conversion to open surgery. In the present study, a retrospective assessment of experience with MS cases was performed with respect to clinical presentation, diagnostic difficulties, surgical procedures, and outcomes. Materials and Methods: Between January 2014 and June 2017, 768 patients with symptomatic cholelithiasis were operated on. Of these, 34 patients had MS. In that group, 24 patients (70.5%) were women and 10 patients (29.5%) were men. Results: The most frequent symptom was abdominal pain, seen in 33 cases (97.1%). The mean age at presentation was 65.53±13.40 years. Obstructive jaundice findings were defined with laboratory tests in 18 patients (52.9%). Surgery was performed in 30 patients (88.2%), and the median time from preoperative hospitalization to surgery was 5 days (range: 0-19 days). The distribution by type of involvment according to preoperative imaging was type I in 9 cases (26.5%), type II in 6 cases (17.6%), type III in 6 cases (17.6%), type IV in 5 cases (14.7%) and, type V in 8 cases (23.5%). Two patients were not operated on as a result of co-morbidities. Furthermore, another 2 patients who had gallstone ileus resolved with medical treatment were not operated on due to co-morbidities. Conclusion: MS is challenging for surgeons. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are useful for an accurate diagnosis and reducing operative complications. Laparoscopic surgery should be considered in patients with type I and in selected cases of type II MS.

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Section: Discussionmentioning

confidence: 99%

“…Rarely, acute pancreatitis, gallbladder perforation and weight loss occurs. [7,[9][10][11] Therefore, it is important to consider MS in the differential diagnosis of obstructive jaundice and acute pancreatitis. [12] Abdominal US is the first preferred imaging method for screening but its sensitivity is low.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of mirizzi syndrome: a single institution's experience of 34 cases

Öter¹

2017

Laparosc Endosc Surg Sci

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Divided Laparoscopic Cholecystectomy for Unusual Gall Stones Complication of Mirizzi’s Syndrome

Lasheen¹,

Baioumy²,

Morsy³

et al. 2015

J Minim Invasive Surg Sci

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Background: Chronic complications of symptomatic gallstone disease such as Mirizzi's syndrome are rare. The importance and implications of these conditions are related to their associated surgical complications which are potentially serious such as bile duct injury and to the modern management when encountered during laparoscopic cholecystectomy. Objectives: This research offers a technique to avoid surgical complications in Mirizzi's syndrome cases during laparoscopic cholecystectomy. Patients and Methods: Between November 2012 and February 2015, 17 patients (12 females and 5 males) with mean age of 51 years (between 29 and 57 years) suffering from Mirizzi's syndrome underwent the divided cholecystectomy. In this technique the gall bladder was divided into two parts above the gall bladder infundibulum. The distal part was dissected for short distance and used to push liver up. The proximal part of gall bladder was cleared from all its contents and reevaluated from inside. Management was achieved according to the stage of disease. Results: The mean operative time was 70 minutes (between 60 and 90 minutes). No biliary tract obstruction or leakage or stenosis was recorded in this patient group during the period of follow up (18 months). Conclusions: Divided laparoscopic cholecystectomy is a safe and effective technique to face the unusual gallstones complications (Mirizzi's syndrome).

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Manejo cirúrgico da síndrome de Mirizzi

Cited by 2 publications

References 13 publications

Surgical outcomes of mirizzi syndrome: a single institution's experience of 34 cases

Surgical outcomes of mirizzi syndrome: a single institution's experience of 34 cases

Divided Laparoscopic Cholecystectomy for Unusual Gall Stones Complication of Mirizzi’s Syndrome

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