Mirizzi syndrome: a surgical challenge

Lacerda, Patrícia de Souza; Ruiz, Manuel Ríos; Melo, Ana; Guimarães, Leonardo Simão Coelho; Silva-Junior, Rubem Alves da; Nakajima, Gerson Suguiyama

doi:10.1590/s0102-67202014000300017

Cited by 14 publications

(12 citation statements)

References 5 publications

(15 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…Mirizzi syndrome is a rare complication of long standing cholelithiasis which occurs in 0.5 to 4% people with gall stone disease [1]. It is more common in females between 21 to 90 years old [1]. The first description about such condition was made by Pablo Luis Mirizzi in 1940 but Mirizzi believed that the condition was more physiological than mechanical, for which he thought that the stone causes inflammatory reaction that stimulates the sphincter in the common hepatic duct resulting in obstruction [2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

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Mirizzi Syndrome with Type F Bile Duct Anomaly- A Rare Case Report

Mahalingam¹

2018

MJCCS

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The Mirizzi's syndrome is an uncommon condition characterized by obstructive jaundice secondary to a gallstone impacted in the infundibulum of gallbladder obstructing the common bile duct. Pre-operative diagnosis is very difficult since clinical findings, laboratory data and radiological features are not specific. We are presenting a 36 year old female presented with obstructive jaundice, cholangitis and acute kidney injury. She was found to have choledocholithiasis with type F biliary anomaly and was managed conservatively with antibiotics and ERCP with biliary stenting. The patient was stabilized and subsequently taken up for surgery. Intra-operatively a type F biliary anomaly with Mirizzi syndrome was made out. Hence cholecystectomy with hepaticojejunostomy including the aberrant duct was done. The case is presented for the interesting and rare association of bile duct anomaly with Mirizzi's syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome with Type F Bile Duct Anomaly- A Rare Case Report

Mahalingam¹

2018

MJCCS

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“…The surgical treatment of the MS requires meticulous dissection plan of the biliary tract in order to perform the cholecystectomy. [15] In the type I MS, LC is the treatment of choice by retrograde dissection of the gallbladder. In some of cases, subtotal cholecystectomy is an alternative to LC where anatomic plans can not be clearly clarified.…”

Section: Discussionmentioning

confidence: 99%

“…The use of the gallbladder infundibulum to close the orifice of the common hepatic duct is an alternative option due to the similar mucosa and vascular tissue as the common bile duct. [15] In patients with type IV MS, a Roux-en-Y hepaticojejunostomy is usually necessary. Alternatively, subtotal chole-cystectomy with choledocoplasty using gallbladder infundibulum can be performed.…”

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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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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“…A pesar de los avances tecnológicos en el campo de laboratorio, el diagnóstico específico preoperatorio de este síndrome reviste dificultades, ya que muchos de los síntomas y signos no son patognomónicos de esta enfermedad, y pueden ser confundidos con otras patologías del sistema digestivo. Además, uno de los métodos diagnósticos preoperatorios más utilizados en nuestro medio para patología vesicular y biliar es la ecografía percutánea, por su accesibilidad y costo pero con limitaciones para la identificación de la obstrucción de la vía biliar, por lo que se debe disponer de la realización de estudios de mayor sensibilidad y especificidad, tales como colangioresonancia o colangiografía endoscópica retrógra-da (esta última para intervencionismo), que dibujan la vía biliar y presentan una sensibilidad que puede ir desde 8 a 62% (18,21) ; si el caso lo amerita queda en reserva la colangiografía percutánea y la ecoendosonografía. Estas ayudas diagnósticas y terapéuticas constituyen una alternativa en forma efectiva y evitan de esta forma las complicaciones…”

Section: Discussionunclassified

Síndrome de Mirizzi “un caso bajo el subdiagnóstico”

Coral

Realpe

Bedoya

2016

RFS

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Se trata de un paciente de sexo masculino de 70 años de edad, oriundo de la ciudad de Pasto, con antecedentes de colelitiasis, sin colecistitis, de 2 años de evolución, quien ingresa el 27 de diciembre del 2012 a urgencias de una Institución Prestadora de Salud (IPS) de la mencionada ciudad, donde se realiza colecistectomía laparoscópica, encontrándose colangitis, vesícula necrótica, piocolecisto, cálculo de 5x6 cm, impactado en cuello vesicular y vesícula fibrótica adherida al lecho hepático. El síndrome de Mirizzi fue descrito por primera vez por Pablo Mirizzi en el año de 1947 y señala factores etiológicos de colestasis extrahepática en algunos pacientes con litiasis vesicular. Esta patología es infrecuente a nivel mundial. En Colombia, y más específicamente en el departamento de Nariño, se carece de publicaciones sobre de este tema; por tal razón se trae a discusión este caso clínico.

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Mirizzi syndrome: a surgical challenge

Cited by 14 publications

References 5 publications

Mirizzi Syndrome with Type F Bile Duct Anomaly- A Rare Case Report

Mirizzi Syndrome with Type F Bile Duct Anomaly- A Rare Case Report

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

Síndrome de Mirizzi “un caso bajo el subdiagnóstico”

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