Mirizzi Syndrome: A Single Center Experience

PURPOSE: Mirizzi syndrome is caused by extrinsic compression of the common hepatic duct by stones impacted in the cystic duct or the gallbladder neck. The standard treatment for Mirizzi syndrome has been open cholecystectomy. The aim of this study was to review our experience of Mirizzi syndrome and consider its surgical treatment. METHODS: Data were collected retrospectively through chart review of 9,360 patients who underwent cholecystectomy between April 1983 and August 2016. RESULTS: Mirizzi syndrome was identified in 21 of 9,360 patients (0.22%). The mean age at diagnosis was 56 years. The most common symptom was abdominal pain (85.7%). A total of 16 patients (76.2%) were diagnosed with McSherry type I and 5 patients (23.8%) with McSherry type II. Laparoscopic cholecystectomy (LC) was initiated in 13 patients and open cholecystectomy (OC) in 8 patients. Conversion from LC to OC was reported for 3 patients (conversion rate 18.8%). In 4 patients with McSherry type II, an additional procedure (T tube insertion or hepaticojejunostomy) was required. CONCLUSION: Preoperative diagnosis of Mirizzi syndrome is very important in order to plan surgical strategy. LC is possible in selected patients with Mirizzi syndrome. However, OC is suitable in patients with McSherry type II. In the near future, laparoscopic procedures may be adaptable in patients with McSherry type II.

The prevention of complications during laparoscopic cholecystectomy (LC) / 中国微创外科杂志

Objective To study the causes and prevention of complications during LC. Methods The clinical data of 1200 patients treated by LC in the latest 10 years were reviewed retrospectively. Results All of the 1200 cases recovered smoothly without severe complications. 18 cases were converted to open-cholecystectomy. Conclutions Complications of LC can be prevented by strict training, serious operative procedures, and mastery of causes and prevention of complications.