[Surgical therapy of benign obstructive jaundice (author's transl)]

The Mirizzi syndrome is the cause of one-third of all cases of benign obstructive jaundice; the therapy is cholecystectomy. Cholangiography is indispensible, manometry and choledochoscopy optional. Choledocholithiasis occurs in 50%. First, the stones are washed out and a Fogarty catheter is used, followed by spoon and forceps. Stenoses of the papilla are mostly dilated; therefore, transduodenal sphincterotomy in fibrotic stenoses should be used for impacted stones and suspected carcinoma of the papilla. The goal is definitive therapy during the first procedure, preserving anatomy and physiology; endoscopic sphincterotomy should be used for the second operation if possible.