Minimally invasive management of Mirizzi syndrome Va: Case series and narrative review of the literature

Gómez, Daniel; Pedraza, Mauricio; Cabrera, Luis Felipe; Mendoza‐Zuchini, Andrés; G, Manuel Arrieta; Aparicio, Steven; Pulido, Jean

doi:10.1016/j.cireng.2022.04.024

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…Ocurre con mayor predominio en el sexo femenino. El riesgo aumenta con la edad, puede ser un hallazgo incidental en el 0.06-5.7% de los pacientes sometidos a colecistectomía (3). La variante más común es la SM tipo 1.…”

Section: Epidemiologíaunclassified

“…Por el índice de riesgo existente con cáncer de vesícula biliar, la biopsia por congelación es un procedimiento indicado (6). En patología biliar la laparoscopía es Gold Standard, pero esto solo se indica para casos de síndrome de Mirizzi tipo 1 (3,4,14).…”

Section: Tratamientounclassified

“…Código médico: MED16937. Correo: fabianmurillo360@gmail.com3 Médica general, graduada de la Universidad Autonoma de Centroamerica (UACA). Código médico: MED16928.…”

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Síndrome de Mirizzi: una patología poco frecuente

Pérez¹,

Barquero²,

Mata

2023

Rev.méd.sinerg.

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El síndrome de Mirizzi es el resultado de la inflamación aguda y crónica causada por un cálculo impactado en la bolsa de Hartmann o el conducto cístico, con obstrucción parcial o completa de la vía biliar principal, y a medida que el proceso inflamatorio progresa, se puede producir obstrucción, necrosis, e incluso fístula biliar interna. Una vez que se produce esta impactación, diversos fenómenos pueden generarse como ictericia, colecistitis aguda, fístula colecisto-coledociana o bilio-digestiva, coledocolitiasis, colangitis y cirrosis biliar secundaria, entre otros. Estos signos y síntomas no siempre son lógicos y ordenados, según la gravedad de cada complicación. Entre los métodos de estudio de imagen disponibles para diagnosticar un síndrome de Mirizzi se encuentran, el ultrasonido abdominal, la tomografía axial computarizada, la colangioresonancia, y la colangiopancreatografía retrógrada endoscópica. El tratamiento del síndrome de Mirizzi más utilizado es la cirugía, se basa esencialmente en la resección de la vesícula biliar y la extracción del cálculo impactado, utilizando diferentes técnicas para reparar el defecto en los casos con fístula. La cirugía laparoscópica no es la más prevenida, considerándola algunos autores como contraindicada, sobre todo en los casos con fístula.

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Section: Epidemiologíaunclassified

Section: Tratamientounclassified

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Síndrome de Mirizzi: una patología poco frecuente

Pérez¹,

Barquero²,

Mata

2023

Rev.méd.sinerg.

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“…The postoperative course was uneventful, and the patient remained symptom-free at the eight-month follow-up. Recently, Gomez et al[95] successfully performed laparoscopic cholecystectomy and fistula resection with primary closure in 16 patients with Mirizzi syndrome type Va.…”

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Mirizzi Syndrome—The Past, Present, and Future

Koo,

Tham,

Toh

et al. 2023

Medicina

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Mirizzi syndrome is a complication of gallstone disease caused by an impacted gallstone in the infundibulum of the gallbladder or within the cystic duct, causing chronic inflammation and extrinsic compression of the common hepatic duct or common bile duct. Eventually, mucosal ulceration occurs and progresses to cholecystobiliary fistulation. Numerous systems exist to classify Mirizzi syndrome, with the Csendes classification widely adopted. It describes five types of Mirizzi syndrome according to the presence of a cholecystobiliary fistula and its corresponding severity, and whether a cholecystoenteric fistula is present. The clinical presentation of Mirizzi syndrome is non-specific, and patients typically have a longstanding history of gallstones. It commonly presents with obstructive jaundice, and can mimic gallbladder, biliary, or pancreatic malignancy. Achieving a preoperative diagnosis guides surgical planning and improves treatment outcomes. However, a significant proportion of cases of Mirizzi syndrome are diagnosed intraoperatively, and the presence of dense adhesions and distorted anatomy at Calot’s triangle increases the risk of bile duct injury. Cholecystectomy remains the mainstay of treatment for Mirizzi syndrome, and laparoscopic cholecystectomy is increasingly becoming a viable option, especially for less severe stages of cholecystobiliary fistula. Subtotal cholecystectomy is feasible if total cholecystectomy cannot be performed safely. Additional procedures may be required, such as common bile duct exploration, choledochoplasty, and bilioenteric anastomosis. Conclusions: There is currently no consensus for the management of Mirizzi syndrome, as the management options depend on the extent of surgical pathology and availability of surgical expertise. Multidisciplinary collaboration is important to achieve diagnostic accuracy and guide treatment planning to ensure good clinical outcomes.

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A rare gastrointestinal bleeding due to a cholecystoduodenal fistula: a case report

Zippi,

Toma,

Hong

et al. 2023

Egypt Liver Journal

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Background Gastrointestinal bleeding from cholecystoduodenal fistula is rare. It is usually managed surgically, although a conservative approach is reported in isolated cases. Case presentation A 71-year-old male patient was admitted to the emergency department (ED) presenting melena associated with severe anemia, requiring a blood transfusion. An urgent upper endoscopy showed the intestinal orifice of a cholecystoduodenal fistula. This finding was confirmed by radiological examination and laparoscopy. Cholecystectomy and simultaneous excision of the fistula were successfully performed. As a result, a diagnosis of Mirizzi syndrome type Va was also made. Conclusion A cholecystoduodenal fistula orifice leading to gastrointestinal bleeding is difficult to diagnose without an endoscopic examination of the upper digestive tract. Following this first diagnostic step, a comprehensive patient examination should be conducted, specifically if a history of gallbladder lithiasis has been reported.

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Minimally invasive management of Mirizzi syndrome Va: Case series and narrative review of the literature

Cited by 3 publications

References 16 publications

Síndrome de Mirizzi: una patología poco frecuente

Síndrome de Mirizzi: una patología poco frecuente

Mirizzi Syndrome—The Past, Present, and Future

A rare gastrointestinal bleeding due to a cholecystoduodenal fistula: a case report

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