Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/135391
Título: Laparoscopic management of type II Mirizzi syndrome
Autores/as: Senra, Fátima
Navaratne, Lalin
Acosta Mérida, María Asunción 
Martínez-Isla, Alberto
Clasificación UNESCO: 32 Ciencias médicas
3213 Cirugía
Palabras clave: Cholecystocholedochal fistula
LABEL
Laparoscopy
Mirizzi syndrome
Transinfundibular approach, et al.
Fecha de publicación: 2020
Publicación seriada: Surgical Endoscopy 
Resumen: Background: Mirizzi syndrome is an uncommon complication of longstanding gallstone disease. Pre-operative diagnosis is challenging, and to date, there is no consensus on the standard management for this condition. Until recently open cholecystectomy was the standard of care for type II Mirizzi syndrome (McSherry classification). The objective of this study was to assess the incidence and management of type II Mirizzi syndrome in patients with proven or suspected choledocholithiasis undergoing laparoscopic common bile duct (CBD) exploration and present our experience in the laparoscopic management of this rare condition over the last 21 years. Methods: Prospective data collection of eleven cases of type II Mirizzi syndrome amongst a series of 425 laparoscopic bile duct explorations was performed between 1998 and 2019. Demographic, clinical, diagnostic, intra-operative, and post-operative data were recorded. Results: The incidence of type II Mirizzi syndrome was 2.6% in 425 laparoscopic CBD explorations. All operations were completed laparoscopically with closure of the defect over a decompressed CBD (T-tube n = 3, antegrade stent n = 5, transcystic drain n = 2), and in one case a non-drained duct was closed with Endoloop. Stone clearance rate was 100% (11 cases). In two patients the transinfundibular approach was used in conjunction with holmium laser lithotripsy to enable choledochoscopy and successful stone clearance. Three patients were complicated in the post-operative period with bile leak (n = 2) and lower respiratory tract infection (n = 1). An incidental gallbladder carcinoma was found in one patient. Conclusion: Laparoscopic management of type II Mirizzi syndrome is feasible and safe when performed by experienced laparoscopic foregut surgeons. Laparoscopy and choledochoscopy can be combined with novel approaches and techniques to increase the likelihood of treatment success.
URI: http://hdl.handle.net/10553/135391
ISSN: 0930-2794
DOI: 10.1007/s00464-019-07316-6
Fuente: Surgical Endoscopy [ISSN 0930-2794], v. 34, p. 2303-2312 (Marzo 2020)
Colección:Artículos
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