Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease
Background. Mirizzi syndrome is a condition difficult to diagnose and treat, representing a particular “challenge” for the biliary surgeon. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. Furthermore, it increases the risk of intraoperative biliary inju...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/6962090 |
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| author | Gennaro Clemente Andrea Tringali Agostino M. De Rose Elena Panettieri Marino Murazio Gennaro Nuzzo Felice Giuliante |
| author_facet | Gennaro Clemente Andrea Tringali Agostino M. De Rose Elena Panettieri Marino Murazio Gennaro Nuzzo Felice Giuliante |
| author_sort | Gennaro Clemente |
| collection | DOAJ |
| description | Background. Mirizzi syndrome is a condition difficult to diagnose and treat, representing a particular “challenge” for the biliary surgeon. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. Furthermore, it increases the risk of intraoperative biliary injury during cholecystectomy. The aim of this study is to point out some particular aspects of diagnosis and treatment of this condition. Methods. The clinical records of patients with Mirizzi syndrome, treated in the last five years, were reviewed. Clinical data, cholangiograms, preoperative diagnosis, operative procedures, and early and late results were examined. Results. Eighteen consecutive patients were treated in the last five years. Presenting symptoms were jaundice, pain, and cholangitis. Preoperative diagnosis of Mirizzi syndrome was achieved in 11 patients, while 6 had a diagnosis of gallbladder cancer and 1 of Klatskin tumor. Seventeen patients underwent surgery, including cholecystectomy in 8 cases, bile duct repair over T-tube in 3 cases, and hepaticojejunostomy in 4 cases. Two cases (11.1%) of gallbladder cancer associated with the Mirizzi syndrome were incidentally found: a patient underwent right hepatectomy and another patient was unresectable. The overall morbidity rate was 16.6%. There was no postoperative mortality. An ERCP with stent insertion was required in three cases after surgery. Sixteen patients were asymptomatic at a mean distance of 24 months (range: 6-48) after surgery. Conclusions. Mirizzi syndrome requires being treated by an experienced biliary surgeon after a careful assessment of the local situation and anatomy. The preoperative placement of a stent via ERCP can simplify the surgical procedure. |
| format | Article |
| id | doaj-art-9ace4ff029ad4de58426c4d95a047dc5 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-9ace4ff029ad4de58426c4d95a047dc52025-02-03T01:32:25ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/69620906962090Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary DiseaseGennaro Clemente0Andrea Tringali1Agostino M. De Rose2Elena Panettieri3Marino Murazio4Gennaro Nuzzo5Felice Giuliante6Department of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Surgical Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyDepartment of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, ItalyBackground. Mirizzi syndrome is a condition difficult to diagnose and treat, representing a particular “challenge” for the biliary surgeon. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. Furthermore, it increases the risk of intraoperative biliary injury during cholecystectomy. The aim of this study is to point out some particular aspects of diagnosis and treatment of this condition. Methods. The clinical records of patients with Mirizzi syndrome, treated in the last five years, were reviewed. Clinical data, cholangiograms, preoperative diagnosis, operative procedures, and early and late results were examined. Results. Eighteen consecutive patients were treated in the last five years. Presenting symptoms were jaundice, pain, and cholangitis. Preoperative diagnosis of Mirizzi syndrome was achieved in 11 patients, while 6 had a diagnosis of gallbladder cancer and 1 of Klatskin tumor. Seventeen patients underwent surgery, including cholecystectomy in 8 cases, bile duct repair over T-tube in 3 cases, and hepaticojejunostomy in 4 cases. Two cases (11.1%) of gallbladder cancer associated with the Mirizzi syndrome were incidentally found: a patient underwent right hepatectomy and another patient was unresectable. The overall morbidity rate was 16.6%. There was no postoperative mortality. An ERCP with stent insertion was required in three cases after surgery. Sixteen patients were asymptomatic at a mean distance of 24 months (range: 6-48) after surgery. Conclusions. Mirizzi syndrome requires being treated by an experienced biliary surgeon after a careful assessment of the local situation and anatomy. The preoperative placement of a stent via ERCP can simplify the surgical procedure.http://dx.doi.org/10.1155/2018/6962090 |
| spellingShingle | Gennaro Clemente Andrea Tringali Agostino M. De Rose Elena Panettieri Marino Murazio Gennaro Nuzzo Felice Giuliante Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease Canadian Journal of Gastroenterology and Hepatology |
| title | Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease |
| title_full | Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease |
| title_fullStr | Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease |
| title_full_unstemmed | Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease |
| title_short | Mirizzi Syndrome: Diagnosis and Management of a Challenging Biliary Disease |
| title_sort | mirizzi syndrome diagnosis and management of a challenging biliary disease |
| url | http://dx.doi.org/10.1155/2018/6962090 |
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