[Mirizzi syndrome: experience at Spanish Hospital of Veracruz].

Abstract

BACKGROUND:

Mirizzi syndrome is a complication of gallbladder stones impacted in Hartmann's pouch or cystic duct with compression of the bile duct. The diagnosis is made by imaging studies, although most of them are found through intraoperative surgical findings. Treatment is cholecystectomy and bile duct restoration when needed.

OBJECTIVE:

to analyze a series of cases of Mirizzi syndrome and compare the results with those published in the literature.

CLINICAL CASE:

We report 4 cases with Mirizzi syndrome in a cohort of 1,034 cases studied in the Hospital Español of Veracruz over 21 years.

RESULTS:

In our series the frequency of Mirizzi syndrome was 0.38%, the average age was 32.1 ± 58.4 years, 50% were male gender and 25% had jaundice with a demonstrable liver profile. In 1 case, ultrasound suggested Mirizzi syndrome and percutaneous cholangiography and computed tomography confirmed the diagnosis. All patients underwent laparoscopic cholecystectomy, and 2 transcystic cholangiographies were performed. One case was classified as Type I-A and three as type I-B. (Beltran and Csendes). The postoperative evolution was satisfactory in all and no mortality was presented.

CONCLUSIONS:

Mirizzi syndrome should be suspected in patients with gallstones who develop obstructive jaundice and it must be confirmed with imaging studies. The surgeon must take extreme precautions to avoid accidental injury to the bile ducts.

• Authors: Federico Roesch-Dietlen, Alfonso Gerardo Pérez-Morales, Silvia Martínez-Fernández, José María Remes-Troche, Victoria Alejandra Jiménez-García, Graciela Romero-Sierra
• Journal: Cirugia y cirujanos (Cir Cir) 2013 May-Jun Vol. 81 Issue 3 Pg. 232-6 ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Síndrome de Mirizzi. Experiencia del Hospital Español de Veracruz.
• PMID: 23769254 (Publication Type: Case Reports, Journal Article, Observational Study)

Topics

• Adult
• Aged
• Cholangiocarcinoma (diagnosis)
• Cholangiography (methods)
• Cholecystectomy, Laparoscopic
• Diagnosis, Differential
• Female
• Gallbladder Diseases (epidemiology, surgery)
• Humans
• Jaundice, Obstructive (etiology)
• Male
• Middle Aged
• Mirizzi Syndrome (classification, diagnostic imaging, epidemiology, surgery)
• Retrospective Studies
• Sensitivity and Specificity
• Spain (epidemiology)
• Tomography, X-Ray Computed
• Ultrasonography