title: Multidisciplinary management of Mirizzi syndrome with cholecystobiliary fistula: the value of minimally invasive endoscopic surgery.
abstract: Mirizzi syndrome, a rare complication of gallstones, is defined by obstruction of the main bile duct. This obstruction may worsen and thus result in cholecystobiliary fistula. Surgical management of Mirizzi syndrome is complicated by the presence of inflamed tissue around the hepatic pedicle, making it impossible to distinguish between the main bile duct and the gallbladder. The surgeon's first task is to perform subtotal cholecystotomy (from the fundus of the gallbladder to the neck) without trying to locate the cystic duct. In a second step, the gallstones are extracted and the main bile duct is then repaired. In most cases, a T-tube is used to drain the main bile duct, and abdominal drainage is left in place (in case a bile fistula forms). This study concluded that preoperative drainage of the main bile duct in the treatment of Mirizzi syndrome types II and III is feasible and might help to decrease the postoperative complication rate.
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Fabien
authors.initials: F
authors.lastname: Le Roux
authors.forename: Charles
authors.initials: C
authors.lastname: Sabbagh
authors.forename: Brice
authors.initials: B
authors.lastname: Robert
authors.forename: Thierry
authors.initials: T
authors.lastname: Yzet
authors.forename: Laurent
authors.initials: L
authors.lastname: Dugue
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Joly
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000368:Aged; D001658:Biliary Fistula / Q000209:etiology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D004322:Drainage; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D057792:Mirizzi Syndrome / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult