title: [Mirizzi syndrome: experience at Spanish Hospital of Veracruz].
abstract: BACKGROUND
  Mirizzi syndrome is a complication of gallbladder stones impacted in Hartmann's pouch or cystic duct with compression of the bile duct. The diagnosis is made by imaging studies, although most of them are found through intraoperative surgical findings. Treatment is cholecystectomy and bile duct restoration when needed.
  
  
  OBJECTIVE
  to analyze a series of cases of Mirizzi syndrome and compare the results with those published in the literature.
  
  
  METHODS
  We report 4 cases with Mirizzi syndrome in a cohort of 1,034 cases studied in the Hospital Español of Veracruz over 21 years.
  
  
  RESULTS
  In our series the frequency of Mirizzi syndrome was 0.38%, the average age was 32.1 ± 58.4 years, 50% were male gender and 25% had jaundice with a demonstrable liver profile. In 1 case, ultrasound suggested Mirizzi syndrome and percutaneous cholangiography and computed tomography confirmed the diagnosis. All patients underwent laparoscopic cholecystectomy, and 2 transcystic cholangiographies were performed. One case was classified as Type I-A and three as type I-B. (Beltran and Csendes). The postoperative evolution was satisfactory in all and no mortality was presented.
  
  
  CONCLUSIONS
  Mirizzi syndrome should be suspected in patients with gallstones who develop obstructive jaundice and it must be confirmed with imaging studies. The surgeon must take extreme precautions to avoid accidental injury to the bile ducts.
authors.affiliation: Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México. federicoroesch@hotmail.com
authors.forename: Federico
authors.initials: F
authors.lastname: Roesch-Dietlen
authors.forename: Alfonso Gerardo
authors.initials: AG
authors.lastname: Pérez-Morales
authors.forename: Silvia
authors.initials: S
authors.lastname: Martínez-Fernández
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: Victoria Alejandra
authors.initials: VA
authors.lastname: Jiménez-García
authors.forename: Graciela
authors.initials: G
authors.lastname: Romero-Sierra
mesh_terms: D000328:Adult; D000368:Aged; D018281:Cholangiocarcinoma / Q000175:diagnosis; D002758:Cholangiography / Q000379:methods; D017081:Cholecystectomy, Laparoscopic; D003937:Diagnosis, Differential; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D057792:Mirizzi Syndrome / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Mirizzi syndrome; cholelithiasis; colelitiasis; surgical tratament; síndrome de Mirizzi; tratamiento quirúrgico