Mirizzi syndrome: A retrospective analysis of 84 patients from a single center
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Background: There is a paucity of literature regarding the prevalence of Mirizzi syndrome (MS) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. We aimed to describe the clinical presentation; laboratory, imaging, and ERCP findings; and surgical management of patients with MS at our center. Methods: A retrospective review was performed of the medical records of 3,852 consecutive patients who underwent ERCP between January 2010 to December 2019 at our center. Results: MS was diagnosed in 84 (2.2%) of the patients who underwent ERCP, with 45 male and 39 female patients. Jaundice was the most common symptom (100%) followed by abdominal pain (91.6%). Leukocytosis and altered liver function tests were noted in all our patients. Although most of our patients had one or more pre-procedure imaging studies, MS was confirmed and subclassified based on cholangiographic and intraoperative findings. There were 11 post-cholecystectomy MS patients who opted for endoscopic therapy with repeated biliary stenting. Among the remaining 73 patients, 48 with type I and 21 with type II MS underwent open cholecystectomy, 4 with type III MS received cholecystectomy and choledochoduodenostomy, and another 4 patients with type II MS underwent subtotal cholecystectomy and choledochoplasty. Associated cystic duct abnormalities were noted in 20.2% of patients. Bile duct injuries occurred in 3 patients during an attempted laparoscopic procedure; however, no mortality was reported. Conclusion: Although it is preferable to diagnose MS preoperatively, a preoperative diagnosis is seldom possible. ERCP is both a diagnostic and therapeutic procedure of choice before definitive surgery and helps to identify any associated cystic duct anomalies in these patients.
Abstract
Background: There is a paucity of literature regarding the prevalence of Mirizzi syndrome (MS) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. We aimed to describe the clinical presentation; laboratory, imaging, and ERCP findings; and surgical management of patients with MS at our center. Methods: A retrospective review was performed of the medical records of 3,852 consecutive patients who underwent ERCP between January 2010 to December 2019 at our center. Results: MS was diagnosed in 84 (2.2%) of the patients who underwent ERCP, with 45 male and 39 female patients. Jaundice was the most common symptom (100%) followed by abdominal pain (91.6%). Leukocytosis and altered liver function tests were noted in all our patients. Although most of our patients had one or more pre-procedure imaging studies, MS was confirmed and subclassified based on cholangiographic and intraoperative findings. There were 11 post-cholecystectomy MS patients who opted for endoscopic therapy with repeated biliary stenting. Among the remaining 73 patients, 48 with type I and 21 with type II MS underwent open cholecystectomy, 4 with type III MS received cholecystectomy and choledochoduodenostomy, and another 4 patients with type II MS underwent subtotal cholecystectomy and choledochoplasty. Associated cystic duct abnormalities were noted in 20.2% of patients. Bile duct injuries occurred in 3 patients during an attempted laparoscopic procedure; however, no mortality was reported. Conclusion: Although it is preferable to diagnose MS preoperatively, a preoperative diagnosis is seldom possible. ERCP is both a diagnostic and therapeutic procedure of choice before definitive surgery and helps to identify any associated cystic duct anomalies in these patients.
참고문헌 (32)
- Mirizzi PL, "Sindrome del conduct hepatico", J Int Chir, 8, pp.731~777 (1948)
- Hazzan D, "Combined endoscopic and surgical management of Mirizzi syndrome", Surg Endosc, 13, pp.618~620 (1999)
- Beltran MA, "The relationship of Mirizzi syndrome and cholecystoenteric fistula : validation of a modified classification", World J Surg, 32, pp.2237~2243 (2008)
- Redaelli CA, "High coincidence of Mirizzi syndrome and gallbladder carcinoma", Surgery, 121, pp.58~63 (1997)
- McSherry CK, "The Mirizzi syndrome : suggested classification and surgical therapy", Surg Gastroenterol, 1, pp.219~225 (1982)
- Csendes A, "Mirizzi syndrome and cholecystobiliary fistula : a unifying classification", Br J Surg, 76, pp.1139~1143 (1989)
- Kwon AH, "Preoperative diagnosis and efficacy of laparoscopic procedures in the treatment of Mirizzi syndrome", J Am Coll Surg, 204, pp.409~415 (2007)
- Erben Y, "Diagnosis and treatment of Mirizzi syndrome : 23-year Mayo Clinic experience", J Am Coll Surg, 213, pp.114~119 (2011)
- Xu XQ, "Mirizzi syndrome : our experience with 27 cases in PUMC Hospital", Chin Med Sci J, 28, pp.172~177 (2013)
- Yip AW, "Mirizzi syndrome with cholecystocholedochal fistula : preoperative diagnosis and management", Surgery, 111, pp.335~338 (1992)
- Beltrán MA, "Mirizzi syndrome : history, current knowledge and proposal of a simplified classification", World J Gastroenterol, 18, pp.4639~4650 (2012)
- Abou-Saif A, "Complications of gallstone disease : Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus", Am J Gastroenterol, 97, pp.249~254 (2002)
- Antoniou SA, "Laparoscopic treatment of Mirizzi syndrome : a systematic review", Surg Endosc, 24, pp.33~39 (2010)
- Yonetci N, "The incidence of Mirizzi syndrome in patients undergoing endoscopic retrograde cholangiopancreatography", Hepatobiliary Pancreat Dis Int, 7, pp.520~524 (2008)
- Dorrance HR, "Acquired abnormalities of the biliary tract from chronic gallstone disease", J Am Coll Surg, 189, pp.269~273 (1999)
- Lubbers EJ, "Mirizzi syndrome", World J Surg, 7, pp.780~785 (1983)
- Karakoyunlar O, "Mirizzi’s syndrome must be ruled out in the differential diagnosis of any patients with obstructive jaundice", Hepatogastroenterology, 46, pp.2178~2182 (1999)
- Tan KY, "Mirizzi syndrome : noteworthy aspects of a retrospective study in one centre", ANZ J Surg, 74, pp.833~837 (2004)
- Al-Akeely MH, "Mirizzi syndrome : ten years experience from a teaching hospital in Riyadh", World J Surg, 29, pp.1687~1692 (2005)
- Becker CD, "Preoperative diagnosis of the Mirizzi syndrome : limitations of sonography and computed tomography", AJR Am J Roentgenol, 143, pp.591~596 (1984)
- Safioleas M, "Mirizzi Syndrome: an unexpected problem of cholelithiasis. Our experience with 27 cases", Int Semin Surg Oncol, 5, pp.12~ (2008)
- Binnie NR, "Mirizzi syndrome managed by endoscopic stenting and laparoscopic cholecystectomy", Br J Surg, 79, pp.647~ (1992)
- Yeh CN, "Laparoscopic treatment for Mirizzi syndrome", Surg Endosc, 17, pp.1573~1578 (2003)
- Schäfer M, "Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy", Surg Endosc, 17, pp.1186~1190 (2003)
- Cui Y, "Appraisal of diagnosis and surgical approach for Mirizzi syndrome", ANZ J Surg, 82, pp.708~713 (2012)
- Lledó JB, "Update on the diagnosis and treatment of mirizzi syndrome in laparoscopic era : our experience in 7 years", Surg Laparosc Endosc Percutan Tech, 24, pp.495~501 (2014)
- Chen H, "Current trends in the management of Mirizzi syndrome : a review of literature", Medicine(Baltimore), 97, pp.e9691~ (2018)
- Piccinni G, "Minimally invasive treatment of Mirizzi’s syndrome : is there a safe way?", Report of a case series. Ann Hepatol, 13, pp.558~564 (2014)
- Lim MS, "Laparoscopic treatment for post-cholecystectomy Mirizzi syndrome", Korean J Hepatobiliary Pancreat Surg, 17, pp.79~82 (2013)
- Jones JD, "Single-operator peroral cholangioscopy for extraction of cystic duct stones in postcholecystectomy Mirizzi syndrome", Case Rep Gastrointest Med, 2017, pp.1710501~ (2017)
- Nishimura A, "High coincidence of Mirizzi syndrome and gallbladder carcinoma", Surgery, 126, pp.587~588 (1999)
- Binmoeller KF, "Endoscopic treatment of Mirizzi’s syndrome", Gastrointest Endosc, 39, pp.532~536 (1993)