CLINICAL AND DIAGNOSTIC ASPECTS OF THE TREATMENT OF PATIENTS WITH MIRIZZI SYNDROME
DOI:
https://doi.org/10.32782/2226-2008-2026-1-11Keywords:
Mirizzi syndrome, laparoscopy, cholecystectomy, diagnostics, complicationsAbstract
Introduction. Mirizzi syndrome (MS) is a rare but clinically significant complication of gallstone disease that complicates diagnosis and increases the risk of iatrogenic bile-duct injury. Aim. Improving treatment for patients with MS by retrospectively analyzing diagnostic approaches and surgical outcomes in patients treated in 2014–2024. Materials and methods. We reviewed 1189 records of patients with gallstone cholecystitis; MS was identified in 72 cases (6.05 %). Patients were classified by Csendes (1989): type I 58(80.55 %), type II 11(15.27 %), type III 2(2.77 %), type IV 1(1.38 %). Ultrasound was mandatory for all patients; MRCP (31; 43.05 %), MSCT (6; 8.33 %) and ERCP (1; 1.38 %) were used for diagnostic clarification and operative planning. Results and Discussion. Ultrasound enabled initial suspicion (dilated cystic duct with a stone in 48; 66.66 %) but was insufficient for accurate typing. ERCP was complicated by post-procedural pancreatitis in one case. Type I MS was managed with laparoscopic cholecystectomy, whereas types II–IV required open reconstructive biliary procedures. Postoperative complications occurred in 28 patients (38.88 %); no deaths were recorded. Conclusions. MS management should be type-guided. Routine ultrasound should be complemented – particularly by MRCP – to improve preoperative classification and support safer, individualized surgery.
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