A new classification of Mirizzi syndrome from diagnostic and therapeutic viewpoints.
OBJECTIVE
A new classification of Mirizzi syndrome was developed based on our experience with 30 cases.


METHODS
Using diagnostic and therapeutic criteria, four distinct entities were identified. Type I characterized by stenosis of the common hepatic duct due to a stone impacted in the cystic duct or the neck of the gallbladder. Type II is characterized by fistulization of the common hepatic duct as a result of a stone embedded in the cystic duct or the neck of the gallbladder. Type III is defined by hepatic duct stenosis due to a stone of the confluence, and Type IV by hepatic duct stenosis as a complication of cholecystitis in the absence of calculi impacted in the cystic duct or the neck of the gallbladder.


RESULTS
Of the 30 patients there were 14 Type I, 2 Type II, 6 Type III, and 8 Type IV patients. Distinctive cholangiographic features were identified.


CONCLUSIONS
The therapeutic approach differs from each of the four distinct pathologic entities.
Nagakawa
T
T
Second Department of Surgery (Department of Health Science), School of Medicine, Kanazawa University, Japan.
Ohta
T
T
Kayahara
M
M
Ueno
K
K
Konishi
I
I
Sanada
H
H
Miyazaki
I
I
D000328:Adult; D000368:Aged; D002758:Cholangiography; D002764:Cholecystitis / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D002769:Cholelithiasis / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D003135:Common Bile Duct; D003251:Constriction, Pathologic; D006801:Humans; D008875:Middle Aged; D013577:Syndrome