Mirizzi Syndrome Type IV Successfully Treated with Peroral Single-operator Cholangioscopy-guided Electrohydraulic Lithotripsy: A Case Report with Literature Review.

Abstract

A 76-year-old man presented with liver dysfunction and intrahepatic bile duct dilatation. Imaging studies showed two large stones that had become impacted in the common hepatic duct, which was fused with the gallbladder. The patient was diagnosed with Mirizzi syndrome type IV. Hepaticojejunostomy and stone removal failed due to dense gallbladder adhesions involving the right hepatic artery. The bile flow was temporarily restored; however, the patient experienced cholangitis 16 months later. The stones were extracted via peroral single-operator cholangioscopy (SOC)-guided electrohydraulic lithotripsy. This is the first case in which stones were completely removed by SOC-guided treatment in a patient with Mirizzi syndrome type IV.

• Authors: Hirokazu Kawai, Toshifumi Sato, Masaaki Natsui, Kotaro Watanabe, Ryosuke Inoue, Mayuki Kimura, Kazumi Yoko, Syun-Ya Sasaki, Masashi Watanabe, Taku Ohashi, Akihiro Tsukahara, Norio Tanaka, Yoshihisa Tsukada
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 61 Issue 23 Pg. 3513-3519 (Dec 01 2022) ISSN: 1349-7235 [Electronic] Japan
• PMID: 35569988 (Publication Type: Review, Case Reports, Journal Article)

Topics

• Male
• Humans
• Aged
• Mirizzi Syndrome (surgery)
• Lithotripsy (methods)
• Gallstones (therapy)
• Catheterization