Diagnosis and Treatment of Mirizzi Syndrome: 23-Year Mayo Clinic Experience

Erben, Young; Benavente-Chenhalls, Luis A.; Donohue, John M.; Que, Florencia G.; Kendrick, Michael L.; Reid‐Lombardo, Kaye M.; Farnell, Michael B.; Nagorney, David M.

doi:10.1016/j.jamcollsurg.2011.03.008

Cited by 103 publications

(155 citation statements)

References 11 publications

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“…Its incidence is about 0.2%-1.5% among patients with calculosis of the gallbladder [2,5,6]. These gallstones can produce CBD obstruction by two mechanisms: (1) mechanical obstruction of the hepatic duct because of the proximity of the cystic duct and the common hepatic duct, and (2) secondary inflammation with frequent episodes of cholangitis that leads to gallbladder contraction and consolidation with the common hepatic duct, or development of a fistula from pressure necrosis caused by the impacted stone.…”

Section: Discussionmentioning

confidence: 99%

“…These gallstones can produce CBD obstruction by two mechanisms: (1) mechanical obstruction of the hepatic duct because of the proximity of the cystic duct and the common hepatic duct, and (2) secondary inflammation with frequent episodes of cholangitis that leads to gallbladder contraction and consolidation with the common hepatic duct, or development of a fistula from pressure necrosis caused by the impacted stone. The mean age of presentation is 44 to 62 years [2]. Obstructive jaundice, fever and acute abdominal pain are the most common symptoms in these patients [2,5].…”

Section: Discussionmentioning

confidence: 99%

“…The mean age of presentation is 44 to 62 years [2]. Obstructive jaundice, fever and acute abdominal pain are the most common symptoms in these patients [2,5]. Elevated bilirubin and alkaline phosphatase levels are most often present.…”

Section: Discussionmentioning

confidence: 99%

“…The characteristic feature of Mirizzi syndrome in USG is stone impaction in gallbladder neck with dilatation of proximal biliary system. Although USG is the initial imaging modality, it has limited sensitivity of 8% to 48% in the diagnosis of Mirizzi syndrome [2,9]. Computed topography (CT) scan can identify dilated intrahepatic and extrahepatic ducts with stones in biliary tree but has poor sensitivity of about 40% to 50% [2,10].…”

Section: Discussionmentioning

confidence: 99%

“…In extreme cases, it can lead onto cholecystocholedochal fistula. It is of immense importance to identify the condition prior to cholecystectomy in order to avoid postoperative complications and it also has coincident association with gallbladder carcinoma [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Unraveling Mirizzi Syndrome–Uncommon Cause of Biliary Obstruction: A Case Report

Balasubramanian¹,

Nellaiappan²

2013

J Clin Case Rep

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Mirizzi syndrome is an unusual complication of chronic cholelithiasis due to impacted gallstone in the cystic duct or neck of the gallbladder causing Common Bile Duct (CBD) obstruction. Here, we report a case of middle aged female presenting with acute abdominal pain and jaundice. Endoscopic Retrograde Cholangio Pancreatography (ERCP) revealed a large gallstone in the cystic duct compressing the common bile duct suggestive of Mirizzi syndrome which was managed surgically.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Unraveling Mirizzi Syndrome–Uncommon Cause of Biliary Obstruction: A Case Report

Balasubramanian¹,

Nellaiappan²

2013

J Clin Case Rep

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Surgical outcome of Mirizzi syndrome: Value of endoscopic retrograde cholangiopancreatography and laparoscopic procedures

Yeh

Wang

Liu

et al. 2021

J Hepato Biliary Pancreat

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Background: Laparoscopic cholecystectomy (LC) with associated procedures and endoscopic retrograde cholangiopancreatography (ERCP) have been the standard treatments for both common and rare biliary diseases. Mirizzi syndrome (MS) is a rare and complex biliary condition. We report our experience with MS treatment and investigate the value of laparoscopic procedures and ERCP in patient management. Methods: From 2004 to 2017, 100 consecutive patients with MS were diagnosed by ERCP and underwent surgery in a referral center. Sixty patients were treated with intended LC, and 40 patients were treated with open cholecystectomy (OC). The clinical manifestations, ERCP and associated procedures, surgical procedures, and postoperative outcomes were investigated.Results: The surgical mortality rate was 1%, while the surgical morbidity rate was 15%. The patients treated with intended LC suffered from less morbidity (5%). The percentage of postoperative residual biliary stones was 32% (n = 32), and only three patients underwent re-operation (laparotomy) for stone removal. The laparotomy conversion rate in the intended LC group was 16.7% (10/60). The length of hospitalization for the patients with successful LC was significantly shorter than that for the patients with conversion and intended OC. Csendes classification was a risk factor for conversion from LC to OC (type I vs types II to V, P < .0001). Conclusions: A combination of a laparoscopic procedure and ERCP may provide therapeutic benefits for patients with MS.

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Acute Biliary Disease

Richter

Komar

2013

Common Problems in Acute Care Surgery

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Diagnosis and Treatment of Mirizzi Syndrome: 23-Year Mayo Clinic Experience

Cited by 103 publications

References 11 publications

Unraveling Mirizzi Syndrome–Uncommon Cause of Biliary Obstruction: A Case Report

Unraveling Mirizzi Syndrome–Uncommon Cause of Biliary Obstruction: A Case Report

Surgical outcome of Mirizzi syndrome: Value of endoscopic retrograde cholangiopancreatography and laparoscopic procedures

Acute Biliary Disease

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