Untangling the biliary puzzle: A Mirizzi syndrome laparoscopic approach case report

Mirizzi syndrome is a rare complication of biliary lithiasis, resulting from a chronic inflammatory process caused by the compression exerted by a stone lodged in the Hartmann's pouch. Management to a Mirizzi syndrome presents a significant surgical challenge.

We report a case of an 83-year-old female patient with recurrent episodes of obstructive jaundice and uncomplicated cholangitis, ultimately diagnosed with a Mirizzi Syndrome and a cholecistobiliary fistula following endoscopic retrograde cholangiopancreatography (ERCP). Intraoperative findings confirmed a type III Mirizzi syndrome, which was successfully managed by laparoscopic approach, without significant postoperative complications.

In complex cases of Mirizzi syndrome involving cholecistobiliary fistula the question remains between open and minimally invasive approach, with high conversion rates in the latter. While laparoscopic cholecystectomy remains the gold standard for type I, the minimally invasive approach for Types II to V remains a subject of debate. This clinical case demonstrates that a minimally invasive approach can be used for more complicated patients.

This case highlights the role of minimally invasive surgery in managing this condition.