Mirizzi syndrome from type I to Vb: a single center experience
Mauricio Gonzalez-Urquijo1, Gerardo Gil-Galindo2, Mario Rodarte-Shade1
1Department of Surgery, Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
2Clinic of Surgery, Metropolitano Hospital, Monterrey, Mexico
Abstract
Objective: The present study describes a cohort of patients diagnosed with Mirizzi syndrome from type I to Vb, over a period of four years. It aimed to identify diagnostic and management pitfalls of Mirizzi syndrome, as well as their concomitant cholecystobiliary or cholecystoenteric fistulas.
Material and Methods: We retrospectively reviewed all electronic medical records of patients who underwent surgery for Mirizzi syndrome at a single institution.
Results: Twenty-two patients (0.6%) were diagnosed with Mirizzi syndrome. Most of the patients were females (n=19, 86.3%). Mean age was 43.8 years (range: 21-71 years). Ultrasound was performed in all (100%) patients. Six (27.2%) patients had a CT scan and six (27.2%) patients had endoscopic retrograde cholangiopancreatography. Overall preoperative diagnosis was achieved on 36.6% (n=8) of the patients. There were the same total and partial cholecystectomies, accounting for ten (45.5%) cases each, one hepaticojejunostomy with cholecystectomy (4.5%), and one enterolithotomy (4.5%). Laparoscopic cholecystectomy was attempted in 15 (68.1%) patients, with conversion to open surgery in 93.3% (n=14) of the patients. An open approach was made in five (22.7%) cases. Four (18.1%) patients were reported as MS type I, both types II and III each account for 22.7% (n=5) of the cases, there was only one (4.5%) patient with type IV, and seven (31.8%) patients with type V.
Conclusion: There are limited studies of patients with Mirizzi syndrome, including type V classification, and when this syndrome is suspected, a preoperative diagnosis should be made to avoid bile duct injuries or lesions to adjacent organs.
Keywords: Biliary disease, cholecystectomy, cholecystobiliary fistula, cholecystoenteric fistula, gallstone disease, mirizzi syndrome
Cite this article as: Gonzalez-Urquıjo M, Gıl-Galindo G, Rodarte-Shade M. Mirizzi syndrome from type I to Vb: a single center experience. Turk J Surg 2020; 36 (4): 399-404.
The approval for this study was obtained from Hospital Zembrano Hellion Ethics Committee (Decision No: 098, Date: 18.11.2019).
Written informed consent was obtained from patient who participated in this case.
Externally peer-reviewed.
Concept - M.G.U.; Design - G.G.G.; Supervision - M.G.U.; Materials - M.G.U.; Data Collection and/or Processing - M.G.U.; Analysis and/or Interpretation - M.G.U.; Literature Search - M.G.U.; Writing Manuscript - M.G.U.; Critical Reviews - G.G.G., M.R.S.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.