Laparoscopic Resection of Cholecystocolic Fistula and Subtotal Cholecystectomy by Tri-Staple in a Type V Mirizzi Syndrome.

Fahri Yetişir,Omer Yazıcıoğlu,Akgün Ebru Şarer,Basar Basaran,Hasan Zafer Acar,Omer Parlak

doi:10.1155/2016/6434507

Fahri Yetişir, Omer Yazıcıoğlu + Show 4 more

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https://doi.org/10.1155/2016/6434507

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Abstract

The Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann's pouch that mechanically obstructs the common bile duct (CBD). We would like to report laparoscopic subtotal cholecystectomy (SC) and resection of cholecystocolic fistula by the help of Tri-Staple™ in a case with type V MS and cholecystocolic fistula, for first time in the literature. A 24-year-old man was admitted to emergency department with the complaint of abdominal pain, intermittent fever, jaundice, and diarrhea. Two months ago with the same complaint, ERCP was performed. Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy were performed by the help of Tri-Staple. At the eight-month follow-up, he was symptom-free with normal liver function tests. In a patient with type V MS and cholecystocolic fistula, laparoscopic resection of cholecystocolic fistula and SC can be performed by using Tri-Staple safely.

Highlights

Mirizzi syndrome (MS) is a rare cause of intermittent or constant obstructive jaundice, where an impacted stone in the cystic duct or Hartmann’s pouch mechanically obstructs the common bile duct (CBD)
MS was first described in 1948, as a repeated inflammation of the gallbladder due to an impacted gallstone. This leads to the formation of adhesions between the gallbladder and the CBD resulting in anatomic distortion of these structures [1]
Abdominal ultrasound showed that so many calculi were present in gallbladder and a large calculus was located in cystic duct

Summary

Introduction

Mirizzi syndrome (MS) is a rare cause of intermittent or constant obstructive jaundice, where an impacted stone in the cystic duct or Hartmann’s pouch mechanically obstructs the common bile duct (CBD). MS was first described in 1948, as a repeated inflammation of the gallbladder due to an impacted gallstone. This leads to the formation of adhesions between the gallbladder and the CBD resulting in anatomic distortion of these structures [1]. It generally occurs in females with advanced age. Correct surgical approach and management are very important for MS as chronic biliary tree inflammation and bile duct anatomic alteration necessitate a rigorous technique [5]. Reinforced Reload with Tri-Staple Technology) in a case with type V MS with cholecystocolic fistula

Presentation of Case

Discussion

Findings

Conclusion