Safety and feasibility of laparoscopic approaches for the management of Mirizzi syndrome: a systematic review

Zhao, Jianwen; Fan, Ying; Wu, Shuodong

doi:10.1007/s00464-020-07785-0

Cited by 15 publications

(38 citation statements)

References 33 publications

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“…According to our review, making a preoperative diagnosis is still difficult, but the numbers vary greatly-between 12% and 84%. Many authors underline the importance of a preoperative diagnosis of MS to avoid exposing surgeons to difficult operating conditions and therefore to limit complications by choosing the right approach [43][44][45][46]. Along with a precise diagnosis, proper treatment must follow.…”

Section: Discussionmentioning

confidence: 99%

“…Along with a precise diagnosis, proper treatment must follow. Open cholecystectomy is in general accepted as the procedure of choice, yet some studies recommend a laparoscopic approach, which is said to be safe, especially when there is no cholecystobiliary fistula [20,43]. However, it is crucial that MS is diagnosed preoperatively when planning laparoscopic treatment.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is crucial that MS is diagnosed preoperatively when planning laparoscopic treatment. Research shows a high conversion rate when the diagnosis in not made prior to the surgery and this increases with the advancement of the disease [43,47].…”

Section: Discussionmentioning

confidence: 99%

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The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

et al. 2021

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Mirizzi syndrome occurs in up to 6% of patients with cholecystolithiasis. It is generally caused by external compression of the common hepatic duct by a gallstone impacted in the neck of the gallbladder or the cystic duct, which can lead to fistulisation. The aim of this review was to highlight the proposed classifications for Mirizzi syndrome (MS) and to provide an update on modern approaches to the diagnosis of this disease. We conducted research on various internet databases and the total number of records was 993, but after a gradual process of elimination our final review consisted of 21 articles. According to the literature, the Cesendes classification is the most commonly used, but many new suggestions have appeared. Our review shows that the ultrasonography (US) is the most frequently used method of initial diagnosis, despite still having only average sensitivity. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are good methods and are similarly effective, but only the latter can be simultaneously therapeutic. Some modern methods show very high sensitivity, but are not so commonly administered. Mirizzi syndrome is still a diagnostic challenge, despite the advancement of the available tools. Preoperative diagnosis is crucial to avoid complications during treatment. New research may bring a unification of classifications and diagnostic algorithms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

et al. 2021

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“…Laparotomy is regarded as the gold standard treatment for MS. Minimally invasive approaches may also be considered but remain controversial because of severe adhesion in Calot’s triangle, increased risk of bile duct injury, and a high open conversion rate [ 2 ]. However, several recent studies reported that various laparoscopic approaches following endoscopic management are feasible and safe, with the advantages of decreased invasiveness, fewer postoperative complications, less operative blood loss, and shorter hospital stay than laparotomy [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Approach Using Digital Single-Operator Peroral Cholangioscopy-Guided Electrohydraulic Lithotripsy and Endoscopic Nasogallbladder Drainage for the Management of High-Grade Mirizzi Syndrome

2021

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Mirizzi syndrome is a rare complication of gallbladder disease that can be difficult to treat. In particular, endoscopic treatment often fails because of the inability to access or to capture the impacted cystic duct stone. We report a case of Mirizzi syndrome grade III that was successfully managed by digital single-operator peroral cholangioscopy-guided electrohydraulic lithotripsy with endoscopic nasogallbladder drainage and interval laparoscopic cholecystectomy. Based on our experience, digital single-operator peroral cholangioscopy-guided electrohydraulic lithotripsy with endoscopic nasogallbladder drainage is a feasible minimally invasive approach for the management of high-grade Mirizzi syndrome.

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“…MS has long been a dilemma for surgeons, especially when laparoscopic surgery is performed[ 5 , 6 ]. The diagnosis and management of MS are still challenging[ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical strategies for Mirizzi syndrome: A ten-year single center experience

Lai¹,

Yang²,

Xu³

et al. 2022

WJGS

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BACKGROUND Mirizzi syndrome (MS) remains a challenging biliary disease, and its low rate of preoperative diagnosis should be resolved. Moreover, technological advances have not resulted in decisive improvements in the surgical treatment of MS. Complex bile duct lesions due to MS make surgery difficult, especially when the laparoscopic approach is adopted. The safety and long-term effect of MS treatment need to be guaranteed in terms of preoperative diagnosis and surgical strategy. AIM To analyze preoperative diagnostic methods and the safety, effectiveness, prognosis and related factors of surgical strategies for different types of MS. METHODS The clinical data of MS patients who received surgical treatment from January 1, 2010 to December 31, 2020 were retrospectively reviewed. Patients with malignancies, choledochojejunal fistula, lack of data and lost to follow-up were excluded. According to preoperative imaging examination records and documented intraoperative findings, the clinical types of MS were determined using the Csendes classification. The safety, effectiveness and long-term prognosis of surgical treatment in different types of MS, and their interactions with the clinical characteristics of patients were summarized. RESULTS Sixty-six patients with MS were included (34 males and 32 females). Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) showed specific imaging features of MS in 58 cases (87.9%), which was superior to ultrasound scan (USS) in the diagnosis of MS and more sensitive to subtle biliary lesions than USS. The overall laparoscopic surgery completion rate was 53.03% (35/66), where the completion rates of MS type I, II and III were 69.05% (29/42), 42.86% (6/14) and zero (0/10), respectively. Thirty-one patients (46.97%) underwent laparotomy or conversion to laparotomy including 11 cases of iatrogenic bile duct injury which occurred in type I patients, and 25 of these patients underwent bile duct exploration, repair and T-tube drainage. In addition, 25 patients underwent intraoperative choledochoscopy and T-tube cholangiography. Overall, 21 cases (31.8%) were repaired by simple suturing, and 14 cases (21.2%) were repaired using the remaining gallbladder wall patch in the subtotal cholecystectomy. The ascendant of the Csendes classification types led to an increase in surgical complexity reflected by increased operation time, bleeding volume and cost. Gender, acute abdominal pain and measurable stone size had no effect on Csendes type of MS or final surgical approach. Age had no effect on the classification of MS, but it influenced the final surgical approach, hospital stay and cost. A total of 66 patients obtained a relatively high preoperative diagnostic rate and underwent surgery safely without serious complications, and no mortality was observed during the follow-up period of 36.5 ± 26.5 mo (range 13-76, median 22 mo). CONCLUSION ...

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Safety and feasibility of laparoscopic approaches for the management of Mirizzi syndrome: a systematic review

Cited by 15 publications

References 33 publications

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

Minimally Invasive Approach Using Digital Single-Operator Peroral Cholangioscopy-Guided Electrohydraulic Lithotripsy and Endoscopic Nasogallbladder Drainage for the Management of High-Grade Mirizzi Syndrome

Surgical strategies for Mirizzi syndrome: A ten-year single center experience

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