[Mirizzi syndrome: experience of 77 cases]

Mirizzi syndrome is estimated to occur in about 1% of cases requiring urgent or elective biliary tract surgery. The key anatomic finding is extrinsic compression of the common duct by a stone located in the gallbladder or cystic duct. Among patients operated on in the last 12 years we have found 77 patients meeting criteria to diagnose Mirizzi syndrome. 76% were females, usually over 40 years of age; jaundice was present in 98% and elevated alkaline phosphatase in 97% of cases. Percutaneous transhepatic cholangiography allowed the diagnosis in 32 of 41 patients. The most common surgical technique involved a patch repair of the gallbladder over the Kehr tube in 45 patients. Eight patients required biliary-jejunal bypass. Eleven patients were reoperated on for benign stenosis of the biliary tract over a 1 month to 10 year period of follow up.