Online ISSN: 2515-8260

MIRIZZI’S SYNDROME: A DIAGNOSTIC DIALEMMA

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1.Dr Mahendra Bendre,2.Dr Vinayak Kshirsagar

Abstract

Mirizzi’s syndrome is characterized by external compression of extra hepatic biliary system by impacted gall stone in cystic duct or infundibulum of gall bladder leading to obstructive jaundice and development of cholecystobiliary fistula in advanced cases. Csendes has described 4 types of the syndrome. In spite of modern investigations like MRCP/CTS available, preoperative diagnosis is not always obtained and it may present as surprise during cholecystectomy. We have done a retrospective study of 7 cases of Mirizzi’s syndrome, in which preoperative diagnosis was obtained only in 3 cases. Cholecystectomy was performed in 2 cases, while 3 cases needed choledochoplasty in addition. Hepaticojejunostomy was needed in addition to cholecystectomy in 2 cases of TypeIII /IV respectively. Utmost care must be exerted during difficult cholecystectomy cases keeping possibility of Mirizzi’s syndrome as culprit and appropriate surgical procedure performed for the treatment.

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