Mirizzi's syndrome surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
The treatment of choice is surgical excision of the [[gallbladder]] and reconstruction of the [[common hepatic duct]] and [[common bile duct]]. | * The treatment of choice in Mirizzi's syndrome is surgical excision of the [[gallbladder]] and reconstruction of the [[common hepatic duct]] and [[common bile duct]]. | ||
* Total [[cholecystectomy]] or [[subtotal]] cholecystectomy (in case of severe inflammation) is usually performed in Mirizzi’s syndrome Type I using open or [[laparoscopic]] surgical technique. <ref name="pmid23002333">{{cite journal |vauthors=Beltrán MA |title=Mirizzi syndrome: history, current knowledge and proposal of a simplified classification |journal=World J. Gastroenterol. |volume=18 |issue=34 |pages=4639–50 |date=September 2012 |pmid=23002333 |pmc=3442202 |doi=10.3748/wjg.v18.i34.4639 |url=}}</ref> | |||
*[[Partial]]/[[Subtotal cholecystectomy]] is done for Type II-Type III <ref name="pmid22901276">{{cite journal |vauthors=Cui Y, Liu Y, Li Z, Zhao E, Zhang H, Cui N |title=Appraisal of diagnosis and surgical approach for Mirizzi syndrome |journal=ANZ J Surg |volume=82 |issue=10 |pages=708–13 |date=October 2012 |pmid=22901276 |doi=10.1111/j.1445-2197.2012.06149.x |url=}}</ref> | |||
* [[Choledochol-enteric anastomosis]] may be required in some cases with [[fistula]]. <ref name="pmid29369192">{{cite journal |vauthors=Chen H, Siwo EA, Khu M, Tian Y |title=Current trends in the management of Mirizzi Syndrome: A review of literature |journal=Medicine (Baltimore) |volume=97 |issue=4 |pages=e9691 |date=January 2018 |pmid=29369192 |pmc=5794376 |doi=10.1097/MD.0000000000009691 |url=}}</ref> | |||
* [[Cholecystectomy]] and [[Roux-en-Y]] [[hepaticojejunostomy]] ([[RYHJ]]) is thought to be the best treatment for Type IV. <ref name="pmid25462668">{{cite journal |vauthors=Lledó JB, Barber SM, Ibañez JC, Torregrosa AG, Lopez-Andujar R |title=Update on the diagnosis and treatment of mirizzi syndrome in laparoscopic era: our experience in 7 years |journal=Surg Laparosc Endosc Percutan Tech |volume=24 |issue=6 |pages=495–501 |date=December 2014 |pmid=25462668 |doi=10.1097/SLE.0000000000000079 |url=}}</ref> <ref name="pmid23741207">{{cite journal |vauthors=Rayapudi K, Gholami P, Olyaee M |title=Mirizzi syndrome with endoscopic ultrasound image |journal=Case Rep Gastroenterol |volume=7 |issue=2 |pages=202–7 |date=May 2013 |pmid=23741207 |pmc=3670630 |doi=10.1159/000351170 |url=}}</ref> | |||
* [[Laparotomy]] should be done for Type V Mirrizzi’s syndrome. <ref name="pmid23741207">{{cite journal |vauthors=Rayapudi K, Gholami P, Olyaee M |title=Mirizzi syndrome with endoscopic ultrasound image |journal=Case Rep Gastroenterol |volume=7 |issue=2 |pages=202–7 |date=May 2013 |pmid=23741207 |pmc=3670630 |doi=10.1159/000351170 |url=}}</ref> | |||
* [[Laparoscopic]] techniques are usually reserved for Type I Mirizzi’s syndrome. It is avoided in other types due to increased risk of biliary injury from severe inflammation and anatomical distortion. <ref name="pmid23741207">{{cite journal |vauthors=Rayapudi K, Gholami P, Olyaee M |title=Mirizzi syndrome with endoscopic ultrasound image |journal=Case Rep Gastroenterol |volume=7 |issue=2 |pages=202–7 |date=May 2013 |pmid=23741207 |pmc=3670630 |doi=10.1159/000351170 |url=}}</ref> | |||
* [[Endoscopy]] and [[robot-assisted surgery]] with or without [[electrohydraulic]] [[lithotripsy]] or [[laser lithotripsy]] are some of the other procedures that are being used. <ref name="pmid23741207">{{cite journal |vauthors=Rayapudi K, Gholami P, Olyaee M |title=Mirizzi syndrome with endoscopic ultrasound image |journal=Case Rep Gastroenterol |volume=7 |issue=2 |pages=202–7 |date=May 2013 |pmid=23741207 |pmc=3670630 |doi=10.1159/000351170 |url=}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 05:15, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Surgery
- The treatment of choice in Mirizzi's syndrome is surgical excision of the gallbladder and reconstruction of the common hepatic duct and common bile duct.
- Total cholecystectomy or subtotal cholecystectomy (in case of severe inflammation) is usually performed in Mirizzi’s syndrome Type I using open or laparoscopic surgical technique. [1]
- Partial/Subtotal cholecystectomy is done for Type II-Type III [2]
- Choledochol-enteric anastomosis may be required in some cases with fistula. [3]
- Cholecystectomy and Roux-en-Y hepaticojejunostomy (RYHJ) is thought to be the best treatment for Type IV. [4] [5]
- Laparotomy should be done for Type V Mirrizzi’s syndrome. [5]
- Laparoscopic techniques are usually reserved for Type I Mirizzi’s syndrome. It is avoided in other types due to increased risk of biliary injury from severe inflammation and anatomical distortion. [5]
- Endoscopy and robot-assisted surgery with or without electrohydraulic lithotripsy or laser lithotripsy are some of the other procedures that are being used. [5]
References
- ↑ Beltrán MA (September 2012). "Mirizzi syndrome: history, current knowledge and proposal of a simplified classification". World J. Gastroenterol. 18 (34): 4639–50. doi:10.3748/wjg.v18.i34.4639. PMC 3442202. PMID 23002333.
- ↑ Cui Y, Liu Y, Li Z, Zhao E, Zhang H, Cui N (October 2012). "Appraisal of diagnosis and surgical approach for Mirizzi syndrome". ANZ J Surg. 82 (10): 708–13. doi:10.1111/j.1445-2197.2012.06149.x. PMID 22901276.
- ↑ Chen H, Siwo EA, Khu M, Tian Y (January 2018). "Current trends in the management of Mirizzi Syndrome: A review of literature". Medicine (Baltimore). 97 (4): e9691. doi:10.1097/MD.0000000000009691. PMC 5794376. PMID 29369192.
- ↑ Lledó JB, Barber SM, Ibañez JC, Torregrosa AG, Lopez-Andujar R (December 2014). "Update on the diagnosis and treatment of mirizzi syndrome in laparoscopic era: our experience in 7 years". Surg Laparosc Endosc Percutan Tech. 24 (6): 495–501. doi:10.1097/SLE.0000000000000079. PMID 25462668.
- ↑ 5.0 5.1 5.2 5.3 Rayapudi K, Gholami P, Olyaee M (May 2013). "Mirizzi syndrome with endoscopic ultrasound image". Case Rep Gastroenterol. 7 (2): 202–7. doi:10.1159/000351170. PMC 3670630. PMID 23741207.