What causes Mirizzi syndrome?
Mirizzi syndrome is defined as common hepatic duct obstruction caused by extrinsic compression from an impacted stone in the cystic duct or infundibulum of the gallbladder [1-3]. Patients with Mirizzi syndrome can present with jaundice, fever, and right upper quadrant pain.
What causes biliary fistula?
Biliary fistulas are commonly reported as a complication of cholecystectomy, common bile duct exploration, inadvertent operative injury of the bile duct, or penetrating trauma.
What is Bilioenteric fistula?
Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases.
How many types of Mirizzi syndrome are there?
In 1989 Csendes et al[7], modified the classification of McSherry by dividing Mirizzi syndrome into four types.
Is Mirizzi syndrome curable?
Surgery remains the preferred approach for the treatment of Mirizzi Syndrome. Laparoscopic cholecystectomy (LC), which has been used since 1987, was first reported to successfully treat Type 1 Mirizzi Syndrome by Paul et al.
Is Mirizzi syndrome fatal?
Extremely high levels of malignancy markers cancer antigen (CA) 19-9 have been found in patients and often have been mistakenly and incorrectly labelled as malignancy. Total mortality associated with Mirizzi syndrome is estimated to range from 5% to 31% [1].
Can gallbladder cause fistula?
Secondary biliary fistulas are caused by iatrogenic injury during cholecystectomy, either performed by open or laparoscopic surgery. The main condition favoring injury is an unclear anatomy of the biliary tract due to local peritonitis, inflammation, or bleeding during the operation.
What is bile fistula?
A biliary fistula is a type of fistula in which bile flows along an abnormal connection from the bile ducts into nearby hollow structure. Types of biliary fistula include: bilioenteric fistula: abnormal connection to small bowel, usually duodenum.
What is Cholecystocholedochal fistula?
Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula.
What is Choledochoduodenal fistula?
Choledochoduodenal fistula (CDF) is defined as an abnormal passage between the common bile duct (CBD) and duodenum. It mostly affects patients of older age, and is an unusual clinical entity in children.
Is Mirizzi syndrome painless?
Mirizzi syndrome presenting as painless jaundice: a rare entity diagnosed by EUS – Gastrointestinal Endoscopy.
Is Mirizzi syndrome rare?
Mirizzi syndrome is a rare cause of bile duct obstruction secondary to extrinsic compression of the hepatic duct by stones impacted in the cystic duct or infundibulum of the gallbladder.
What is Mirizzi syndrome type 2?
Mirizzi syndrome occurs when a stone becomes impacted in the neck of the gallbladder or cystic duct, causing extrinsic compression of the common bile duct. Type II: Subtotal cholecystectomy, surgical repair of fistula (suture repair, choledochoplasty), and exploration of CBD
Can Mirizzi syndrome be treated with laparoscopic surgery?
Laparoscopic treatment of patients with Mirizzi syndrome is feasible, particularly for type I disease. 61 Careful preoperative workup is essential to prevent injury to the bile duct. Yet laparoscopic treatment presents a formidable challenge.
What causes cholecystocholedochal fistula?
An impacted stone in the gallbladder infundibulum or cystic duct can compress the bile duct, usually at the level of the common hepatic duct (type I), or a stone can erode from the gallbladder or cystic duct into the common hepatic duct, resulting in a cholecystocholedochal fistula (type II).
What is a Type 4 cholecystoenteric fistula?
This system grades the cholecystobiliary involvement from type I (external compression of the bile duct) to type IV (complete destruction of the bile duct). 59 Mirizzi syndrome has also been associated with cholecystoenteric fistula formation.
