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A new classification of Mirizzi syndrome from diagnostic and therapeutic viewpoints
T Nagakawa1, T Ohta, M Kayahara
1Second Department of Surgery (Department of Health Science), School of Medicine, Kanazawa University, Japan.
Background/Aims:
A new classification of Mirizzi syndrome was developed based on our experience with 30 cases.
Material And Methods:
Using diagnostic and therapeutic criteria, four distinct entities were identified. Type I characterized by stenosis of the common hepatic duct due to a stone impacted in the cystic duct or the neck of the gallbladder. Type II is characterized by fistulization of the common hepatic duct as a result of a stone embedded in the cystic duct or the neck of the gallbladder. Type III is defined by hepatic duct stenosis due to a stone of the confluence, and Type IV by hepatic duct stenosis as a complication of cholecystitis in the absence of calculi impacted in the cystic duct or the neck of the gallbladder.
Results:
Of the 30 patients there were 14 Type I, 2 Type II, 6 Type III, and 8 Type IV patients. Distinctive cholangiographic features were identified.
Conclusion:
The therapeutic approach differs from each of the four distinct pathologic entities.