Mirizzi syndrome--two case reports and a short review of the literature

The authors have analyzed the problem of Mirizzi syndrome (MS) and found in the literature that it was reported in 0.3% to 3% of patients undergoing cholecystectomy. Anatomic disorder, especially the presence of cholecystocholedochal fistula, increases the risk of bile duct injury during cholecystectomy, albeit more often during laparoscopic than laparotomic cholecystectomy. A comparative study was performed regarding the incidence of MS in two groups of patients: 332 patients in Zrenjanin in the year 2009, and 531 patients in Belgrade in the year 2005, with an incidence of MS found in 2 patients in Zrenjanin (0.63%) and 4 patients in Belgrade (0.75%). The incidence rate was 6% in Zrenjanin and 7.5% in Belgrade, but there was no statistically significant difference between the two groups. All patients with MS were diagnosed during the operative period using operative cholangiography. During preoperative diagnosis, patients underwent laboratory ultrasound examination, and those who were suspected of having an anatomic disorder underwent operative cholangiography, although patients today more often undergo choledochoscopy then cholangiography. MS according to classification by Csendes was found in all 6 patients undergoing operation.