Gallstone Disease

Type III Mirizzi, successfully treated with a free gallbladder flap, a case report

“…Pablo Luis Mirizzi was one of the best biliary surgeons of the last century; he was the first surgeon to perform an intraoperative cholangiography successfully. Nonetheless, we usually recognize him by the syndrome that is named after him [ 1 , 2 ]. In 1948 he described the condition in with an impacted stone in the gallbladder infundibulum causes jaundice by extrinsic compression of the common bile duct [ 1 ].…”

“…In 1948 he described the condition in with an impacted stone in the gallbladder infundibulum causes jaundice by extrinsic compression of the common bile duct [ 1 ]. The stone can also erode from the gallbladder into the bile duct producing a fistula [ 2 , 3 ]. It wasn't until 1983, where Csendes et al classified the common bile duct’s involvement in the fistula [ 1 , 4 ].…”

“…Gallstone disease and its complications are among the most common surgical interventions worldwide; the arrival of better diagnostic and treatment modalities has improved patient outcomes [ [1] , [2] , [3] ]. Although gallstone disease is generally associated with cholecystitis, rare events such as Mirizzi syndrome can represent a challenge for the biliary surgeon, as they can significantly increase the risk of intraoperative biliary injury [ 3 ].…”

“…Although gallstone disease is generally associated with cholecystitis, rare events such as Mirizzi syndrome can represent a challenge for the biliary surgeon, as they can significantly increase the risk of intraoperative biliary injury [ 3 ]. Preoperative diagnosis, safe surgical techniques, and referring the patient to a specialized center can improve the patient's outcome and reduce troublesome complications [ 1 , 2 ]. We present the case of a 61-year-old patient, a type III Mirizzi syndrome was identified and successfully treated with a gallbladder free flap.…”

Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1

“…Mirizzi syndrome, the obstruction of the common hepatic duct by a gallstone impacted at the gallbladder neck or cystic duct, occurs in 0.1% of gallstone disease. 64,65 Common presenting symptoms include fever, right upper quadrant pain, and obstructive jaundice. MRCP or even ultrasonography may be diagnostic, showing stone(s) within the cystic duct or neck of the gallbladder as well as extrinsic narrowing of the common hepatic duct with upstream dilatation.…”