Related Experiment Videos
Mirizzi's syndrome: experience from a multi-institutional review
L W Johnson1, J K Sehon, W C Lee
1Department of Surgery, Louisiana State University School of Medicine, Shreveport, USA.
The American Surgeon
|February 24, 2001
Summary
Mirizzi's syndrome, a rare complication of gallstones, causes jaundice and can lead to biliary cirrhosis. Open surgical techniques are recommended for diagnosis and repair due to lower complication rates compared to laparoscopic approaches.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Surgical Oncology
Background:
- Mirizzi's syndrome involves common hepatic duct obstruction from impacted gallstones.
- It presents with jaundice, cholangitis, and potentially biliary cirrhosis.
- Diagnosis can be challenging due to intermittent symptoms and potential bilio-biliary fistulas.
Purpose of the Study:
- To review cases of Mirizzi's syndrome managed over a 24-year period.
- To evaluate diagnostic and operative approaches, including open and laparoscopic techniques.
- To compare complication rates between surgical methods for Mirizzi's syndrome.
Main Methods:
- Retrospective chart review of 11 Mirizzi's syndrome cases.
- Analysis of presentation, workup, operative findings, and repair techniques.
- Literature review to compare open versus laparoscopic approaches.
Main Results:
- Eleven cases of Mirizzi's syndrome (Csendes Type I-III) were identified and managed.
- Open surgical technique was used for all definitive diagnoses and repairs.
- Four laparoscopic procedures were converted to open due to anatomical challenges.
Conclusions:
- Mirizzi's syndrome is rare, occurring in <0.5% of cholelithiasis patients.
- Open biliary surgery is the preferred approach for suspected or diagnosed Mirizzi's syndrome.
- Roux-en-y hepaticojejunostomy is indicated for complex cases with compromised duct viability.