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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Hepatobiliary+Surg+Nutr
2017 ; 6
(3
): 170-178
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Updates in Mirizzi syndrome
#MMPMID28653000
Valderrama-Treviño AI
; Granados-Romero JJ
; Espejel-Deloiza M
; Chernitzky-Camaño J
; Barrera Mera B
; Estrada-Mata AG
; Ceballos-Villalva JC
; Acuña Campos J
; Argüero-Sánchez R
Hepatobiliary Surg Nutr
2017[Jun]; 6
(3
): 170-178
PMID28653000
show ga
Mirizzi syndrome, known as extrinsic bile compression syndrome, is a rare
complication of cholecystitis and chronic cholelithiasis, secondary to the
obliteration of the infundibulum of the gallbladder or cystic duct caused by the
impact of one or more calculations in these anatomical structures, which leads to
compression of the adjacent bile duct, resulting in partial or complete
obstruction of the common hepatic duct, triggering liver dysfunction. Our aim is
to identify and describe the current epidemiology, diagnostic methods, and
treatment of Mirizzi syndrome. A literature search was performed using different
databases, including Medline, Cochrane, Embase, Medscape, PubMed, using keywords:
Mirizzi syndrome, epidemiology, markers, pathophysiology, clinical presentation,
diagnosis, and treatment. Selected original articles, review articles or case
reports from 1997 to 2015 were collected, written in English or Spanish. The
endoscopic retrograde cholangiopancreatography (ERCP) is the most accurate
diagnostic method. The traditional treatment has been surgery and involves an
incision at the bottom of the gallbladder and calculus removal. If fistulas are
observed, it is performed a partial cholecystectomy; otherwise, a
cholecystocholedochoduodenostomy is an alternative. Endoscopic treatment includes
biliary drainage and stone extraction. Many surgeons claim that laparoscopic
cholecystectomy is contraindicated in Mirizzi syndrome because of the presence of
inflammatory tissue and adhesions in the Calot's triangle. If dissection is
attempt, it can cause unnecessary injury to the bile duct. However, other
surgeons consider the laparoscopic approach is feasible, although technically
challenging. Currently, laparoscopic cholecystectomy for this condition is
considered controversial and technically challenging; however, it has shown that
with the right skills and equipment, it is a safe and feasible way to treat some
cases of Mirizzi syndrome type I and II.