title: A new classification of Mirizzi syndrome from diagnostic and therapeutic viewpoints.
abstract: 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.
authors.affiliation: Second Department of Surgery (Department of Health Science), School of Medicine, Kanazawa University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nagakawa
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.forename: M
authors.initials: M
authors.lastname: Kayahara
authors.forename: K
authors.initials: K
authors.lastname: Ueno
authors.forename: I
authors.initials: I
authors.lastname: Konishi
authors.forename: H
authors.initials: H
authors.lastname: Sanada
authors.forename: I
authors.initials: I
authors.lastname: Miyazaki
mesh_terms: 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