Delayed Cholecystectomy Management for Mirizzi Syndrome

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Case Reports

Background:

• Mirizzi syndrome involves common hepatic duct obstruction by cystic duct stones, causing inflammation and distorted biliary anatomy.
• Surgical management is often challenging, with open subtotal cholecystectomy being the most reported technique, while laparoscopic approaches are less common.

Purpose of the Study:

• To report a unique case of Mirizzi syndrome managed with a delayed laparoscopic cholecystectomy.
• To highlight a potential alternative management strategy for Mirizzi syndrome, particularly in cases with severe acute inflammation.

Main Methods:

• A case presentation of an 11-year-old female with Mirizzi syndrome.
• Initial laparoscopic cholecystectomy aborted due to inflammation, followed by endoscopic biliary decompression.
• Successful interval laparoscopic cholecystectomy performed six weeks later.

Main Results:

• The patient presented with symptoms consistent with Mirizzi syndrome.
• Laparoscopic cholecystectomy was initially unsuccessful due to severe inflammation.
• Endoscopic decompression provided temporary relief, and a delayed laparoscopic cholecystectomy was successfully completed.

Conclusions:

• Delayed cholecystectomy can be a safe and effective strategy for managing Mirizzi syndrome.
• This approach may help avoid technically demanding laparoscopic procedures during the acute inflammatory phase.
• This case underscores the importance of considering staged surgical interventions for complex hepatobiliary conditions.