Combined laparoscopic and endoscopic treatment for Mirizzi syndrome

To summarize our experience and results of combined endoscopic and laparoscopic treatment for Mirizzi syndrome (MS) retrospectively, and to evaluate the effect of the procedures of minimally invasive strategy.

Fifty-four patients with Mirizzi syndrome were admitted to our centre. Endoscopic procedures were performed firstly to identify the Csendes Types and alleviate jaundice. Different laparoscopic surgeries were adopted according to Csendes Types. The clinical data about operation and recovery of the two groups was recorded and compared.

Total 63 endoscopic procedures were performed successfully in 46 cases and failed in 3 cases. Five patients were found to have MS intraoperatively. Endoscopic complication rate was 31.7% (20/63). Forty-three patients underwent laparoscopic surgeries successfully and 7 cases were converted to open surgeries. The average laparoscopic operation time was 83.2±34.7min and postoperative hospital stay was 9.5±2.4 days. Postoperative complication rate was 16.3%. Median follow-up period was 38.6 (range, 16-83) months and 4 stone recurrence occurred.

Combined endoscopic and laparoscopic approaches in treating patients with MS are technically feasible and minimally invasive. However, laparoscopic primary suture of the defect on the wall of common bile duct is difficult; hence it is recommended it be performed by experienced hands.