Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy.

Details

Serval ID
serval:BIB_11BF6D5D27EA
Type
Article: article from journal or magazin.
Collection
Publications
Title
Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy.
Journal
Surgical endoscopy
Author(s)
Schäfer M., Schneiter R., Krähenbühl L.
ISSN
1432-2218 (Electronic)
ISSN-L
0930-2794
Publication state
Published
Issued date
08/2003
Peer-reviewed
Oui
Volume
17
Number
8
Pages
1186-90; discussion 1191-2
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Benign extrinsic obstruction of the hepatic duct, known as "Mirizzi syndrome" (MS), is an uncommon complication of longstanding cholelithiasis. Since laparoscopic cholecystectomy (LC) replaced the open approach, Mirizzi syndrome has regained the interest of biliary surgeons.
The Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTS) prospectively collected the data on 13,023 patients undergoing LC between 1995 and 1999. This database was investigated with special regard to patients with Mirizzi syndrome.
There were 39 patients (14 men and 25 women; mean age, 61 years) with MS (incidence, 0.3%). Thirty-four patients had type 1 MS and five had type 2. A gallbladder carcinoma was found in four patients (incidence, 11%). In the type 1 group, 23 patients underwent cholecystectomy only, 10 patients had a bile duct exploration and T-tube insertion, and one patient had a Roux-en-Y reconstruction. In three patients with type 2, a hepaticojejunostomy was performed; two others underwent simple closure and drainage (via T-tube) of the biliary fistula. The conversion rate was 74% (24 of 34 patients) in the type 1 group and 100% (five of five patients) for type 2. The overall complication rate was 18%. There were no deaths.
Although MS is rarely encountered during LC, it must be recognized intraoperatively. Conversion to an open approach is often needed, and prior to any surgical intervention, gallbladder cancer must be excluded.
Keywords
Aged, Anastomosis, Roux-en-Y, Biliary Fistula/complications, Carcinoma/complications, Carcinoma/surgery, Cholangitis/etiology, Cholecystectomy, Laparoscopic/methods, Choledochostomy, Cholelithiasis/complications, Cholelithiasis/surgery, Cholestasis, Extrahepatic/epidemiology, Cholestasis, Extrahepatic/etiology, Cholestasis, Extrahepatic/surgery, Common Bile Duct Diseases/complications, Female, Gallbladder Diseases/complications, Gallbladder Neoplasms/complications, Gallbladder Neoplasms/surgery, Hepatic Duct, Common, Humans, Incidence, Intraoperative Care, Male, Middle Aged, Prospective Studies, Syndrome
Pubmed
Web of science
Create date
11/12/2018 15:43
Last modification date
20/08/2019 13:39
Usage data