| Revista: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000412889 |
| ISSN: | 1665-2681 |
| Autors: | Piccinni, Giuseppe1 Sciusco, Andrea1 Luca, Giuseppe Massimiliano de1 Gurrado, Angela1 Pasculli, Alessandro1 Testini, Mario1 |
| Institucions: | 1Universita degli Studi di Bari Aldo Moro, Bari, Puglia. Italia |
| Any: | 2014 |
| Període: | Sep-Oct |
| Volum: | 13 |
| Número: | 5 |
| Paginació: | 558-564 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico, analítico |
| Resumen en inglés | Mirizzi’s syndrome (MS) is a rare complication of the inveterate biliary lithiasis. Diagnostic and therapeutic standardization is still missing, especially since laparoscopic cholecystectomy has become the gold standard approach for symptomatic cholelithiasis. Our study is a retrospective analysis based on a case-series. It considered 370 cholecystectomies performed from 2006 to 2011. We selected 11 patients affected by MS (2.97%). We divided them according to Csendes’ classification. Endoscopic Retrograde Cholangio-Pancreatography (ERCP) was used for biliary drainage when the patient suffered jaundice and/or cholangitis and, preoperatively, to confirm the suspicion of MS obtained through Magnetic Resonance Cholangio-Pancreatography (MRCP). We found it useful to exploit nasobiliary drainage (NBD) for intra-operative check of the biliary tree. In all 5 patients of the type 1 group MS was discovered intraoperatively and treated with Laparoscopic Sub-total Cholecystectomy (LSC). One patient suffered from biliary leakage, solved with NBD positioning. The type 2 group was made up of 2 women and 1 man. All of them were preoperatively submitted to ERCP and NBD positioning. Two underwent LSC and one was converted to laparotomy. The type 3 was represented by a 63-year-old woman suffering from recurrent cholangitis. She was submitted to MRCP, ERCP and then underwent LSC. The 2 patients affected by type 4 underwent open biliary reconstruction. In conclusion, every attempt should be made to identify MS prior to LCS since it will allow NBD insertion by ERCP. Once LCS is initiated, if MS is identified intra-operatively, we can provide the most practical surgical options |
| Disciplines | Medicina |
| Paraules clau: | Cirugía, Diagnóstico, Gastroenterología, Síndrome de Mirizzi, Fístula colecisto-biliar, Colecistectomía laparoscópica, Técnicas quirúrgicas |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Surgery, Mirizzi syndrome, Cholecysto-biliary fistula, Laparoscopic cholecystectomy, Surgical techniques |
| Text complet: | Texto completo (Ver PDF) |
