Surgical strategies for Mirizzi syndrome: A ten-year single center experience

Lai, W. Michael; Yang, Jie; Xu, Nan; Chen, Junhua; Chen, Yang; Yao, Huihua

doi:10.4240/wjgs.v14.i2.107

Cited by 9 publications

(4 citation statements)

References 39 publications

(64 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surgical management is the mainstay treatment for MS, and the surgical approach varies according to each case [ 26 ]. The safest approach to manage MS Type V is always laparotomy since it has the advantage of better visualization, haptic feedback and gallbladder calculus removal before cholecystectomy and the best results were observed after a cholecystectomy and Roux-en-Y hepaticojejunostomy [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Mirizzi syndrome type V complicated with triple fistula: a case report

Lalountas,

Smyrlis,

Mouratidis

et al. 2023

surg case rep

View full text Add to dashboard Cite

Background Mirizzi syndrome (MS) is a complicated form of longstanding, symptomatic cholelithiasis. According to Beltran Classification MS Type V has been introduced to describe the cholecystoenteric fistula, with or without gallstone ileus. Mirizzi syndrome Type V with double fistula has been reported in the past; however, the triple fistula is an even rarer case, first described in the international literature so far. Case presentation A 77-year-old male was admitted to our surgical department with recurrent episodes of abdominal pain, which initially presented in the last 6 months and was accompanied with jaundice. Computed tomography showed findings of cholelithiasis, pneumobilia and choledocholithiasis. We performed an ERCP, which showed two fistulas of the gallbladder with the pyloric antrum and the duodenum, respectively. Surgical treatment was immediately undergone and during laparotomy, we confirmed these findings. We ligated and dissected these communications. In addition, a third fistula between the gallbladder and the common bile duct was identified. An insertion of a Kehr T-tube into the common bile duct was performed via the gallbladder. After 3 months, the Kehr T-tube was removed and in the subsequent 2 years of follow-up the patient was presented without complications. Conclusions Mirizzi syndrome complicated with triple fistula, first described in the international literature, to the best of our knowledge, confirms the long natural history of inflammation.

show abstract

Section: Discussionmentioning

confidence: 99%

Mirizzi syndrome type V complicated with triple fistula: a case report

Lalountas,

Smyrlis,

Mouratidis

et al. 2023

surg case rep

View full text Add to dashboard Cite

show abstract

“…MRCP has an imaging effect close to that of X-ray cholangiography with contrast, which shows not only the biliary system but also the surrounding tissue structures and anatomical patterns when combined with conventional MR cross-sectional imaging. This technique has the advantages of a non-invasive nature, favorable patient compliance, no need for contrast agents, and unique imaging, which allow its application in the diagnosis of Mirizzi syndrome and can elevate the preoperative diagnosis rate of this condition[ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Type I Mirizzi syndrome treated by electrohydraulic lithotripsy under the direct view of SpyGlass: A case report

Liang,

Jia,

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.

show abstract

“…Patients with MS should be evaluated comprehensively based on MRI/MRCP. Open surgery or timely conversion to open surgery should be selected when preoperative evaluation or LC intraoperative exploration shows that laparoscopic surgery is unsuitable [44,45]. However, most surgeons do not recommend LC as a viable standard of treatment due to the increased risk of bile duct injury and a high conversion rate with this condition.…”

Section: Open Surgerymentioning

confidence: 99%