Laparoscopic treatment of Mirizzi syndrome: a systematic review

Abstract

Current evidence suggests that laparoscopic treatment of Mirizzi syndrome cannot be recommended as a standard procedure. Preoperative diagnosis of the syndrome seems an important predicting factor of technical success.

Unraveling Mirizzi Syndrome–Uncommon Cause of Biliary Obstruction: A Case Report

“…Although ERCP has a variable sensitivity of 50% to 100% in the diagnosis of Mirizzi syndrome, it is the most accurate imaging technique to identify the cholecysto-choledochal fistula and offers therapeutic drainage of biliary tract [2,3,9]. Increasingly, MRCP has been used for the diagnosis of Mirizzi syndrome.…”

“…Surgical management remains to be the mainstay of treatment but often is associated with high complication rates (around 16%) that are mainly due to postoperative biliary leak and retained gallstone [3]. Surgical management is based on the type of Mirizzi syndrome and degree of inflammation.…”

“…Csendes et al [8] further simplified the classification based upon the extent of fistula formation which is described as follows, Type 1: Extrinsic compression of CBD without a cholecystocholedochal fistula and has either an intact (IA) or obliterated (IB) cystic duct Type 2: A cholecysto-choledochal fistula involving less than onethird of the circumference of CBD Type 3: A cholecysto-choledochal fistula involving at least twothirds of the circumference of CBD Type 4: A cholecysto-choledochal fistula involving the entire biliary wall of CBD Adequate delineation of the surgical anatomy by preoperative imaging of this condition has been shown to reduce postoperative complication rates [3,8]. The characteristic feature of Mirizzi syndrome in USG is stone impaction in gallbladder neck with dilatation of proximal biliary system.…”

“…In extreme cases, it can lead onto cholecystocholedochal fistula. It is of immense importance to identify the condition prior to cholecystectomy in order to avoid postoperative complications and it also has coincident association with gallbladder carcinoma [1][2][3].…”

Divided Laparoscopic Cholecystectomy for Unusual Gall Stones Complication of Mirizzi’s Syndrome

“…The impacted gallstones together with the inflammatory response, cause first external obstruction of the bile duct, and eventually erode into the bile duct evolving into a cholecystocholedochal or cholecystohepatic fistula with different degrees of relation between the gallbladder and bile duct (6,7). Serious complications as bile duct injuries are common during modern surgical management of Mirizzi's syndrome especially in undiagnosed cases (8,9).…”