Endoscopic Nasogallbladder Drainage Combined with Laparoscopic Surgery for Type I Mirizzi Syndrome with Acute Cholecystitis: A Case Series Report

Han, Wei; Yue, Qing; Liu, Kai; Ke, Jing; Meng, Lingyu; Liu, Yahui

doi:10.1155/2020/2417539

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Out of 17 analyzed studies, 6 had zero conversion rate [6,[17][18][19][20][21]. In the analyzed literature, most common causes of conversion were unclear or abnormal anatomy and severe adhesions (conversion rate 25.5-67%) [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

et al. 2022

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Objectives: Mirizzi syndrome (MS) is a condition when an impacted stone in the cystic duct or the Hartmann’s pouch due to its extrinsic compression and concomitant inflammation causes an obstruction of the common bile duct. Laparotomy was the preferred surgical technique to treat this syndrome. However, with advances in technologies, an increasing number of surgeons are starting to choose minimally invasive surgery. The objective of this study is to review existing literature relating to minimally invasive surgery treatment of MS. Methods: PubMed and ClinicalKey were used to search and identify relevant articles since January 2000 to December 2020. The following keywords were applied: Mirizzi syndrome, laparoscopy, minimally invasive. The criteria for exclusion were applied: case reports with less than 2 patients, nonsurgical treatments, and reviews were excluded from this study. Results: Thirty-two articles were identified for analysis, 17 (540 patients in total) of these articles fulfilled the inclusion criteria: 8 retrospective studies, 4 case series, and 5 prospective studies. In the analyzed cohort, 295 patients were treated laparoscopically. Out of 17 articles included in the manuscript, 14 articles provided the information on minimally invasive surgery approach. There were 221 minimally invasive surgeries, out of which 143 (64.7%) were successful, thus according to the type of MS: MS I-175 (79.2%), successful 105 (60%); MS II-40 (18%), successful 32 (80%); MS III-6 (2.7%), successful 6 (100%). The mean conversion rate from laparoscopic to open surgery was 26.2% (range 0–67%), and the median complication rate in seventeen studies was 18.1% (range 0–40%), respectively. The female/male ratio was 1.2:1, and the median age in fifteen studies providing overall data on age was 57.4 years (range 40.1–70.1 years). Conclusions: Current evidence presents that open surgery remains the main treatment for MS. Minimally invasive approaches are feasible, safe, and are associated with short-term recovery, significant differences in the operation time and blood loss during operation. However, minimally invasive approaches are mainly restricted to selected patients with type I MS.

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Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

et al. 2022

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“…Therapeutic options such as stenting, nasobiliary drainage, or stone removal may also be performed during the procedure, helping to relieve obstruction preoperatively. 8 One study has demonstrated that pre-op stenting also aids in identifying the common bile duct during surgery in patients with abnormal Triangle of Calot and biliary tree anatomy. 3 Complications may arise from ERCP which include infection and (1.4%) and perforation (0.6%).…”

Section: Discussionmentioning

confidence: 99%

“… 5 While the laparoscopic approach was avoided in the past due to high variability in the hepatobiliary anatomy seen in these patients leading to bile duct injury and high rates of conversion to open laparotomy, newer evidence suggests that the laparoscopic approach after ERCP identification and therapeutic management is a reliable option in patients with a pre-operative diagnosis. 7 , 8 , 11 …”

Section: Discussionmentioning

confidence: 99%

“…Stone removal tends to provide significant relief and is usually done after decompression via biliary drainage either from transhepatic percutaneous drainage or endoscopic nasobiliary tube. 8 , 12 , 13 Coupled with antibiotic therapy and decompression, endoscopic therapies can resolve initial presenting symptoms of cholangitis and obstructive jaundice. While the removal of impacted stones is desirable in non-surgical endoscopic therapy, there are cases where complete stone removal cannot be achieved, either due to anatomical issues or to the stone being impacted above the cystic duct, such as in Hartmann’s pouch.…”

Section: Discussionmentioning

confidence: 99%

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Mirizzi Syndrome: An Unusual Complication of Cholelithiasis

Jesani¹,

Romero²,

Bozkurt³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

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Mirizzi syndrome is a rare condition caused by the obstruction of the common bile duct or common hepatic duct by external compression from multiple impacted gallstones or a single large impacted gallstone in Hartman’s pouch. The condition can easily be confused with choledocholithiasis, bile duct stricture or cholangiocarcinoma due to the presence of obstructive jaundice hence may be overlooked due to the rarity of the condition. The incidence of Mirizzi syndrome among patients with gallstones is reported to range from 0.63 to 5.7%. Furthermore, it poses a differential diagnosis dilemma for the physician as well as radiologists because there are no clinical features or diagnostic procedures that have a 100% specificity and sensitivity. Laparotomy is the preferred surgical technique of choice. For the patients who are poor surgical candidate, mainstay of treatment is biliary stent placement for the restoration of normal biliary drainage. Due to low incidence of the Mirizzi syndrome, an elevated index of suspicion is required to diagnose this condition. At present, there are no well-developed, internationally recognized clinical guidelines for the management of this syndrome. Furthermore, the diagnostic procedures available still pose a barrier in the ability to confirm the diagnosis prior to surgical treatment, even though the diagnostic rate has increased dramatically.

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A retrospective comparison of endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in the treatment of acute cholangitis

Li,

Xu,

Zhao

et al. 2024

mat express

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Endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) can rapidly alleviate obstruction, facilitate bile drainage, and reduce pressure in the bile duct. In this study, to evaluate the effect of plastic biliary stent on the recurrence rate of choledocholithiasis in patients with actual cholangitis after endoscopic retrograde cholangioangiography (ERCP), we a comparative analysis of the efficacy and safety between ENBD and ERBD in inflammatory remission rate, complication rate, and success rate of secondary or multiple endoscopic lithotomy. A total of 347 patients undergoing ENBD and ERBD were enrolled in this retrospective study. Preoperative assessments including blood tests, electrocardiography, abdominal ultrasonography, CT scans, MRI, or MRCP were conducted on all participants. Additionally, serum CRP and amylase levels were measured using a magnetic nanobead-based immunoassay. We found that The success rate of stone removal in the ENBD group was higher than that in the ERBD group (90.8% vs. 72.7%) (P <0.0001). The remission rate of inflammation in the ERBD group (100.0%) was higher than that in the ENBD group (98.7%) (P >0.05). No significant difference was observed between the ERBD group and the ENBD group in preoperative and postoperative inflammatory indexes (total bilirubin, direct bilirubin, white blood cells, neutrophils, CRP, and serum amylase). Moreover, there were significant differences in post-ERCP pancreatitis between the ERBD group and ENBD group. These results suggest that both ENBD and ERBD can effectively improve clinical efficacy. Moreover, magnetic nanobeads have good application in serum index detection to increase detection efficiency.

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Endoscopic Nasogallbladder Drainage Combined with Laparoscopic Surgery for Type I Mirizzi Syndrome with Acute Cholecystitis: A Case Series Report

Cited by 3 publications

References 19 publications

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

Mirizzi Syndrome: Is There a Place for Minimally Invasive Surgery?

Mirizzi Syndrome: An Unusual Complication of Cholelithiasis

A retrospective comparison of endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in the treatment of acute cholangitis

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