Mirizzi's syndrome surgery
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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 is usually performed in Mirizzi’s syndrome Type I.
- Partial/Subtotal cholecystectomy is preferred for Type II-Type III and sometimes Type I in case of severe inflammation. [1]
- choledochol-enteric anastomosis may be required in some cases. [2]
- Cholecystectomy and Roux-en-Y hepaticojejunostomy (RYHJ) is thought to be the best treatment for Type IV. [3] [4]
- Laparotomy should be done for Type V Mirrizzi’s syndrome. [4]
- 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. [4]
- Endoscopy and robot-assisted surgery with or without electrohydraulic lithotripsy or laser lithotripsy are some of the other procedures that are being used. [4]
References
- ↑ 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.
- ↑ 4.0 4.1 4.2 4.3 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.