Diagnostic features and surgical outcomes in patients with Mirizzi syndrome

Abstract

Background: Mirizzi syndrome is a rare complication of longgoing cholelithiasis, commonly accompanied by variety of structural changes in hepatopancreatoduodenal region. Methods: 34 patients underwent surgical treatment. There were 9 (26,4%) male patients and 25 (73,6%) female patients. Median age of 67.3 ± 1,8, ranging from 40 to 83. All patients classified according Beltran and Csendes 2008. Results: Dominant symptom: in 14 cases majority of symptoms indicates on acute cholecystitis, in 18 cases – obstructive jaundice and cholecystitis, in 2 cases –acute small bowel obstruction. Pathological process in patients with initial stages of Mirizzi syndrome (I-II) corrected by cholecystectomy with external drainage of common bile duct, in one case with choledohoduodenoanastomosis. Roux-en-Y hepaticojejunostomy performed in two patients with Mirizzi syndrome III and one - type IV. Optimal treatment for patients with Mirizzi syndrome IV-Va was cholecystectomy with common bile duct repair using gallbladder tissue. Only symptomatic surgery for bowel obstruction performed for patient with Mirizzi syndrome Vb due the severity of patients condition in both cases. Conclusion: With prolongation of disease severity of anatomical changes increases. Surgical treatment of patients with Mirizzi syndromethat requires precise surgical technique and individualized tactics.