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Mirizzi syndrome in a Native American population
M J Curet1, D E Rosendale, S Congilosi
1Department of Surgery, Gallup Indian Medical Center, New Mexico.
American Journal of Surgery
|December 1, 1994
Summary
Mirizzi syndrome, a rare bile duct obstruction, occurred more frequently in Native Americans. Successful surgical management with no long-term issues was achieved in this patient group.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Surgical Pathology
Background:
- Mirizzi syndrome involves common hepatic duct obstruction due to gallstones in the cystic duct or gallbladder neck.
- Bilibiliary fistula formation is common and can lead to biliary ductal injury if not recognized during surgery.
Purpose of the Study:
- To investigate the incidence, complications, and intraoperative management of Mirizzi syndrome in Native Americans.
- To compare the incidence in Native Americans versus non-Native American populations.
Main Methods:
- Retrospective review of 623 biliary tract operations from October 1990 to December 1992.
- Identified 17 patients (2.7%) with Mirizzi syndrome, noting a higher incidence in Native Americans.
Main Results:
- Five patients had Type I Mirizzi syndrome (parallel or obliterated cystic duct).
- Twelve patients had Type II Mirizzi syndrome with a biliobiliary fistula, with 7 closed primarily and 4 over catheters.
- No deaths occurred; 4 major complications (including 1 bile-duct injury) were reported, with no long-term sequelae after a mean 2.5-year follow-up.
Conclusions:
- Mirizzi syndrome in Native Americans can be successfully managed with appropriate diagnostic and surgical techniques.
- The study highlights a higher incidence in this population, emphasizing the need for awareness and tailored management strategies.