Nuevas posibilidades diagn車sticas y terap谷uticas en el s赤ndrome de Mirizzi

作者：Sanchez Beorlequi; J; Cabezali Sanchez; R; Monsalve Laguna; E; Soriano Gil Albarellos; P; Moreno de Marcos; N

来源：Anales de Medicina Interna, 2007.

DOI：10.4321/S0212-71992007000600006

• gallstone disease
• bile duct obstruction
• mirizzi syndrome
• diagnostic
• endoscopic treatment
• laparoscopic surgery.

mirizzi%26apos;s syndrome is an unusual complication of gallstone disease, in which a stone impacting in the neck of the gallbladder (hartmann%26apos;s pouch) compresses the common bile duct. this mechanical obstruction leads to obstructive jaundice frequently followed by inflammatory changes and several complications. we present two patients affected by mirizzi%26apos;s syndrome whose diagnosis was correct in the preoperative period and approached by laparoscopy. a case was converted to open procedure due to adhesions in the calot%26apos;s triangle, and therefore, treated with subtotal cholecystectomy and choledochorrhaphy over a t tube. in the other case the laparoscopy access became successful. both postoperative courses were uneventful. in this article, suitable diagnostic techniques are analyzed. on the other hand, we discuss what is the best therapeutic option, with especial attention to the relevance of endoscopic retrograde cholangiopancreatography and laparoscopic approach in the management of those patients.