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Mirizzi syndrome from type I to Vb: a single center experience
Mauricio Gonzalez-Urquijo1, Gerardo Gil-Galindo2, Mario Rodarte-Shade1
1Department of Surgery, Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
Turkish Journal of Surgery
|March 29, 2021
Summary
Mirizzi syndrome, a rare condition involving bile duct obstruction, presents diagnostic challenges. Early diagnosis is crucial to prevent complications like bile duct injury, especially in complex cases including type V classification.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Surgical Pathology
Background:
- Mirizzi syndrome (MS) is a rare condition characterized by extrinsic compression of the common hepatic duct caused by a gallstone impacted in the cystic duct or gallbladder neck.
- It can lead to cholecystobiliary or cholecystoenteric fistulas, complicating diagnosis and management.
Purpose of the Study:
- To identify diagnostic and management pitfalls in patients with Mirizzi syndrome (MS) types I-Vb.
- To analyze the incidence and characteristics of concomitant cholecystobiliary or cholecystoenteric fistulas in MS patients.
Main Methods:
- Retrospective review of electronic medical records for patients diagnosed with Mirizzi syndrome over a four-year period.
- Analysis of diagnostic imaging (ultrasound, CT, ERCP) and surgical outcomes.
Main Results:
- Twenty-two patients (0.6%) were diagnosed with MS, predominantly females (86.3%) with a mean age of 43.8 years.
- Preoperative diagnosis was achieved in only 36.6% of patients.
- Laparoscopic cholecystectomy was attempted in 68.1% but converted to open surgery in 93.3% of cases. MS type V was the most prevalent (31.8%).
Conclusions:
- Mirizzi syndrome, particularly type V, is underdiagnosed preoperatively.
- Improved preoperative diagnosis is essential to prevent bile duct injuries and adjacent organ damage during surgical management.
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