Laparoscopic subtotal cholecystectomy for Mirizzi syndrome: A report of a case

Jiro, Kimura; Takata, Naokazu; Lefor, Alan Kawarai; Kanzaki, Masaki; Mizokami, Ken

doi:10.1016/j.ijscr.2019.01.010

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Other associated signs or symptoms include fever, nausea, vomiting, anorexia, and weight loss [ 2 , 6 ]. Patients can demonstrate signs of obstructive jaundice such as dark-colored urine and acholic stools [ 15 , 16 ]. A small subset of patients presents asymptomatically [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice

et al. 2022

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Patient: Male, 60-year-old Final Diagnosis: Mirizzi syndrome Symptoms: Dark stools • jaundice • painless jaundice Medication: — Clinical Procedure: ERCP with stent placement • spyglass cholangioscopy Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Isolated painless jaundice is an uncommon presenting sign for Mirizzi syndrome, which is typically characterized by symptoms of acute or chronic cholecystitis. We report a rare case of Mirizzi syndrome with an acute onset of painless obstructive jaundice. Case Report: A 60-year-old man with an unremarkable prior medical history presented with 1 week of jaundice, dark urine, and acholic stools. His laboratory studies revealed a pattern of cholestasis with marked direct hyperbilirubinemia. Ultrasound and magnetic resonance imaging studies demonstrated intrahepatic ductal dilation and cholelithiasis, including a stone within the cystic duct. Endoscopic retrograde cholangiopancreatography with SpyGlass cholangioscopy confirmed the diagnosis of Mirizzi syndrome. Conclusions: An atypical presentation of Mirizzi syndrome should be suspected in the setting of biliary obstruction without pain. The differential diagnosis is broad and includes choledocholithiasis, ascending cholangitis, and hepatobiliary malignancy. Evaluation should include laboratory studies and biliary tract imaging. Noninvasive biliary tract imaging can help exclude malignancy and confirm ductal dilation but is not sensitive for Mirizzi syndrome. Endoscopic retrograde cholangiopancreatography can serve both diagnostic as well as therapeutic purposes via stone extraction and stent placement. SpyGlass cholangioscopy can also augment management in the form of Electrohydraulic lithotripsy. Although therapeutic biliary endoscopy can be very effective, cholecystectomy remains the definitive treatment for Mirizzi syndrome.

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Section: Discussionmentioning

confidence: 99%

Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice

et al. 2022

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“…It means that in these cases, LSRC is effective to treat MSII y III. LSRC, as laparoscopic subtotal “fenestrating” cholecystectomy, had recently been proposed as safe (without biliary injury) and effective (single surgery to solve MS) techniques for difficult operative conditions [3] , [4] , [12] , [13] . There are no studies comparing both techniques in MS Type II & III, but evidence show both procedures prevents conversion and has fewer serious complications [14] , [15] , [16] , [17] .…”

Section: Discussionmentioning

confidence: 99%

“…According to Csendes, MS type II and III are categorized as a fistula of one third and two thirds of the common hepatic duct circumference, respectively [1] . The difficulty to confirm the diagnosis before surgery, the technical challenge due to the severe inflammatory reaction, the difficult identification of normal structures, the need for advance laparoscopic technics to perform a successful surgery and the absence of evidence on the best surgical technique determines a high rate of conversion, reoperation, and risk bile duct injury [2] , [3] , [4] . This case series shows the outcomes of mexican patients who underwent laparoscopic subtotal reconstitutive cholecystectomy (LSRC) for type II and III MS with the aim of determining whether the procedure can be a safe and effective approach in our institution.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic subtotal reconstituting cholecystectomy in type II & III Mirizzi syndrome: Case series of 5 patients

Saavedra

Segovia²,

Centeno³

et al. 2022

International Journal of Surgery Case Reports

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“…In MS, the gallbladder is often fibrosed and adherent to the bile duct. In cases of severe inflammation or anomalous biliary anatomy, intracholecystic approach can help avoid bile duct injury as this technique completely avoids dissecting Calot’s triangle [24, 31, 32]. Opening the gallbladder to remove the impacted stone and to better evaluate the position of the cystic duct and identify the presence of a fistula can be a helpful operative maneuver [7, 31].…”

Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

et al. 2022

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Objectives: Mirizzi syndrome (MS) is a condition when an impacted stone in the cystic duct or the Hartmann’s pouch due to its extrinsic compression and concomitant inflammation causes an obstruction of the common bile duct. Laparotomy was the preferred surgical technique to treat this syndrome. However, with advances in technologies, an increasing number of surgeons are starting to choose minimally invasive surgery. The objective of this study is to review existing literature relating to minimally invasive surgery treatment of MS. Methods: PubMed and ClinicalKey were used to search and identify relevant articles since January 2000 to December 2020. The following keywords were applied: Mirizzi syndrome, laparoscopy, minimally invasive. The criteria for exclusion were applied: case reports with less than 2 patients, nonsurgical treatments, and reviews were excluded from this study. Results: Thirty-two articles were identified for analysis, 17 (540 patients in total) of these articles fulfilled the inclusion criteria: 8 retrospective studies, 4 case series, and 5 prospective studies. In the analyzed cohort, 295 patients were treated laparoscopically. Out of 17 articles included in the manuscript, 14 articles provided the information on minimally invasive surgery approach. There were 221 minimally invasive surgeries, out of which 143 (64.7%) were successful, thus according to the type of MS: MS I-175 (79.2%), successful 105 (60%); MS II-40 (18%), successful 32 (80%); MS III-6 (2.7%), successful 6 (100%). The mean conversion rate from laparoscopic to open surgery was 26.2% (range 0–67%), and the median complication rate in seventeen studies was 18.1% (range 0–40%), respectively. The female/male ratio was 1.2:1, and the median age in fifteen studies providing overall data on age was 57.4 years (range 40.1–70.1 years). Conclusions: Current evidence presents that open surgery remains the main treatment for MS. Minimally invasive approaches are feasible, safe, and are associated with short-term recovery, significant differences in the operation time and blood loss during operation. However, minimally invasive approaches are mainly restricted to selected patients with type I MS.

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Laparoscopic subtotal cholecystectomy for Mirizzi syndrome: A report of a case

Cited by 10 publications

References 16 publications

Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice

Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice

Laparoscopic subtotal reconstituting cholecystectomy in type II & III Mirizzi syndrome: Case series of 5 patients

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

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