Biliobiliary Fistula

Corlette, Marvin B.

doi:10.1001/archsurg.1975.01360100019004

Cited by 82 publications

(13 citation statements)

References 2 publications

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“…The dissection of Calot's triangle may lead to bile duct injury or excessive bleeding and other morbidity such as sepsis, delayed biliary stricture, and secondary biliary cirrhosis. [ 6 8 ]…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic approach is safe and effective in the management of Mirizzi syndrome

et al. 2015

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CONTEXT:Mirizzi syndrome (MS), an unusual complication of gallstone disease is due to mechanical obstruction of the common hepatic duct and is associated with clinical presentation of obstructive jaundice. Pre-operative identification of this entity is difficult and surgical management constitutes a formidable challenge to the operating surgeon.AIM:To analyse the clinical presentation, pre-operative diagnostic strategies, operative management and outcome of patients operated for MS in a tertiary care centre.MATERIALS AND METHODS:This retrospective study identified patients operated for MS between January 2006 and August 2013 and recorded and analysed their pre-operative demographics, pre-operative diagnostic strategies, operative management, and outcome.RESULTS:A total of 20 patients was identified out of 1530 cholecystectomies performed during the study period giving an incidence of 1.4%. There were 11 males and 9 females with a mean age of 55.6 years. Abdomen pain and jaundice were predominant symptoms and alteration of liver function test was seen in 14 patients. Endoscopic retrograde cholangiopancreatography (ERCP) the mainstay of diagnosis was diagnostic of MS in 72% of patients, while the rest were identified intra-operatively. The most common type of MS was Type II with an incidence of 40%. Cholecystectomy was completed by laparoscopy in 14 patients with a conversion rate of 30%. A choledochoplasty was sufficed in most of the patients and none required a hepaticojejunostomy. The laparoscopic cohort had a shorter length of hospital stay when compared to the entire group.CONCLUSION:MS, a rare complication of cholelithiasis is a formidable diagnostic and therapeutic challenge and pre-operative ERCP as a main diagnostic strategy enables the surgeon to identify and minimize bile duct injury. A choledochoplasty might be sufficient in the majority of the types of MS, while a laparoscopic approach is feasible and safe in most cases as well.

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Section: Discussionmentioning

confidence: 99%

“…In the absence of cholecystobiliary fistula (Csendes Type 1), cholecystectomy and removal of the biliary stone constitutes the treatment of choice. [ 8 9 ]…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic approach is safe and effective in the management of Mirizzi syndrome

et al. 2015

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“…This syndrome, which may occur in 0.7-1.4% of patients undergoing cholecystectomy,'-4 is of particular importance because surgery in its presence is associated with an increased incidence of bile duct injury when a standard cholecystectomy technique is used5; indeed the syndrome has been cited as a trap in the surgery of gallstones. 6 It is therefore very important that the diagnosis should be considered in any patient with a history of obstructive jaundice who is being prepared for surgery, and the condition emphasises the value of accurately establishing the anatomical abnormality in such cases pre-operatively (box 1). This article reviews the pathology, clinical presentation and management of this rare syndrome of extrahepatic obstruction.…”

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confidence: 99%

The Mirizzi syndrome

Pemberton

Wells

1997

Postgraduate Medical Journal

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Summary The Mirizzi syndrome is an unusual presentation of gallstones which occurs when a gallstone becomes impacted in either Hartmann's pouch of the gallbladder or the cystic duct, causing obstruction of the common hepatic duct by extrinsic compression. The diagnosis of this syndrome is of importance because surgery in its presence is associated with an increased incidence of bile duct injury. The pathology, clinical presentation and management of this syndrome are discussed, and several illustrative case reports presented.

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“…In such cases, stricture repair of the distal bile duct is indicated for persistent strictures using either Roux-en-Y choledocho-jejunostomy or choledocho-duodenostomy. If cholecysto-choledochal fistula is present, partial cholecystectomy, over sewing the gallbladder cuff and insertion of a T-tube through the fistula is widely regarded as adequate treatment for Type 2 Mirizzi syndrome [13]. Baer et al [14] suggested the insertion of a T-tube through a separate choledochotomy in the distal CBD in order to prevent excessive leakage and stricture at the fistula site.…”

Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome Complicating Acute Cholecystitis: CT Diagnosis

Kassim¹,

Ossibi²,

Traore³

et al. 2016

OJRad

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Mirizzi syndrome is a rare complication of gallstones with an incidence of less than 1% per year in Western countries. Imaging and endoscopy play a key role in its diagnosis. CT scan helps to eliminate any malignant lesion of the bile ducts or liver hence comes in handy in the confirmation of Mirizzi syndrome. We hereby report a case of a Mirizzi syndrome complicating acute cholecystitis in a 41-year-old patient without any history of disease.

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Biliobiliary Fistula

Cited by 82 publications

References 2 publications

Laparoscopic approach is safe and effective in the management of Mirizzi syndrome

Laparoscopic approach is safe and effective in the management of Mirizzi syndrome

The Mirizzi syndrome

Mirizzi Syndrome Complicating Acute Cholecystitis: CT Diagnosis

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