Mirizzi Syndrome: A Review of the Literature

6
Endoscopic treatment of Mirizzi syndro m e
should be used as a temporizing measure before
surgery. It can serve as a definitive treatment for
those patients who are unsuitable surg i c a l
candidates when further endoscopic attempts can
be made to disimpact and remove the stones. Longterm
success appears to be most likely in patients
with type II disease who do not have residual
gallbladder stones [24] .
CONCLUSION
Mirizzi syndrome is a rare complication of
cholelithiasis and requires a high index of suspicion
in the setting of obstructive jaundice. Diagnosis
preoperatively may be elusive with bloodwork, US
and CT alone. Cholangiography (intraoperative
and ERCP) as well as MRCP aids in both the
diagnosis and identification of anatomy and may
p revent serious biliary injury. Surgery is the
mainstay of therapy of Mirizzi syndrome, and
requires the safe completion of cholecystectomy
without injuring the biliary system and the
a p p ropriate management of the cholecystocholedochal
fistula. The aberrant anatomy intrinsic
to this syndrome presents a difficult challenge to
surgeons and the laparoscopic approach should be
undertaken with caution and probably left to
specialized minimally invasive centres. Endoscopic
t reatment may be effective as a temporizing
m e a s u re before surgery and can be definitive
treatment for unsuitable surgical candidates.
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