scholarly journals Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jason Deforest Jones ◽  
Rishi Pawa
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Case Reports ◽  
Disease Process ◽  
Developed Countries ◽  
Young Female ◽  
Mirizzi Syndrome ◽  
Endoscopic Management ◽  
Common Hepatic Duct ◽  
Peroral Cholangioscopy

Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.

Clinical aspects and surgical technique in Mirizzi syndrome: A systematic review

2020 ◽  
pp. 35871-35873
Keyword(s):  
Surgical Technique ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Signs And Symptoms ◽  
Mirizzi Syndrome ◽  
Common Hepatic Duct ◽  
Clinical Aspects ◽  
Main Diagnosis ◽  
Biliary Surgery ◽  
Electronic Library

Mirizzi syndrome is described in the 1940s as follows: partial obstruction of the secondary common hepatic duct by gallstones, impacted on the cystic duct or gallbladder infundibulum, associated with the inflammatory response that involved the cystic duct and the common hepatic duct. As it is a rare and delicate condition, differential diagnosis is extremely important, in which the patient's clinical condition is verified through anamnesis and complementary exams, where immediately after the surgical intervention can be performed. This work aims to describe, through a literature review, the clinical aspects and the surgical technique in Mirizzi Syndrome. Were used as a database for research sites containing scientific articles available online such as Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo) and PubMed. 154 articles were found through the descriptors, where after applying the inclusion and exclusion criteria 11 articles remained to write the work. According to the articles surveyed, it is clear that most of them do not report the syndrome as the main diagnosis, possibly because it is a pathology with signs and symptoms very close to other diseases of the bile duct, therefore leaving the syndrome sometimes described in the context of these other diseases. Finally, it concludes that even though the preoperative diagnosis is rare, it should be suspected in individuals undergoing biliary surgery.

scholarly journals Common hepatic duct obstruction by cystic duct stone: Mirizzi syndrome

1979 ◽  
Vol 132 (6) ◽  
pp. 1007-1009 ◽  
Author(s):  
RE Koehler ◽  
GL Melson ◽  
JK Lee ◽  
J Long
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Mirizzi Syndrome ◽  
Common Hepatic Duct ◽  
Duct Obstruction

Primary Biliary B-Cell Lymphoma of the Cystic Duct Causing Obstructive Jaundice

2007 ◽  
Vol 73 (5) ◽  
pp. 508-510 ◽  
Author(s):  
David H. Jho ◽  
Diana J. Jho ◽  
Gregorio Chejfec ◽  
Maria Ahn ◽  
Evan S. Ong ◽  
...  
Keyword(s):  
B Cell ◽  
Cystic Duct ◽  
Cell Lymphoma ◽  
Hepatic Duct ◽  
B Cell Lymphoma ◽  
Exploratory Laparotomy ◽  
Common Hepatic Duct ◽  
Klatskin Tumor ◽  
Porta Hepatis ◽  
Extrinsic Compression

A distinctive case of primary biliary lymphoma occurring in the cystic duct causing extrinsic compression of the porta hepatis in a 48-year-old woman is presented. Imaging studies revealed stricture of the common hepatic duct with a 2.5-cm nonhomogeneous mass at the porta hepatis, mimicking a Klatskin tumor. Exploratory laparotomy revealed a mass in the gallbladder neck with extension into the cystic duct akin to Mirizzi's syndrome. A soft, tan-yellow 1.0-cm mass was removed from the cystic duct, and infiltrating atypical lymphocytic nodules were identified with a final diagnosis of an anaplastic variant of diffuse large B-cell lymphoma.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals Morphological expression of the extrahepatic bile duct. A study in a sample of Colombian mestizo population

10.3823/2585 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Bladimir Saldarriaga Tellez ◽  
Edgar Giovanni Corzo Gomez ◽  
Pedro Luis Forero Porras ◽  
Luis Ernesto Ballesteros Acuña
Keyword(s):  
Bile Duct ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Descriptive Study ◽  
Great Variability ◽  
Common Hepatic Duct ◽  
Medium Length ◽  
Three Samples ◽  
Morphological Expression

  Background: The great variability of the extrahepatic bile duct (EBD) has clinical-surgical implications. The objective of this study was to characterize the morphological expressions of EBD. Methods and findings This descriptive study, done by injecting a semi-synthetic (Palatal GP40L 85%; styrene 15%) impregnated with mineral green dye into the gallbladder, to determine the anatomical characteristics and the biometrics of EBD in 33 blocks formed from the supra-mesocolic floor.The gallbladder presented a length of 66.9 ± 1.7 mm. The Hartmann´s Pouch was observed in 16 specimens (50%). The lengths of the cystic duct (CD), common hepatic duct (CHD) and common bile duct (choledoch duct) were 27.8 ± 1.6 mm, 28.6 ± 11.39 mm and 60.6 ± 11.6 mm respectively. The presence of accessory hepatic ducts (AHD) was found in three samples (9.1%). In 29 specimens  (87.9%) the cystic duct  presented medium length, while in 4 cases (12.1%) the CD was long (P < 0, 05). The trajectory of the lateral oblique of CD was present in 23 cases (69.7%), with statistically significant differences in relation to the other trajectories of the CD (P <0, 05). In 18 samples (55%) the cystic-hepatic union appeared at the level of the middle third of the EBD, while in 15 (45%) cases the union of the CD was low (P<0,05). Conclusions The mathematical distribution of the segments of the EBD, carried out in this study, provides reliability to the assessment of the cystic-hepatic junction level. The presence of CHA and the level of the cysto-hepatic junction are important anatomical references, especially in emergency room procedures.

scholarly journals Anomalous anatomical variation in extrahepatic biliary tree and pancreas and its related vessels: a cadaveric study

2019 ◽  
Vol 6 (9) ◽  
pp. 3111
Author(s):  
Mahim Koshariya ◽  
Sheikh Behram ◽  
Jay Prakash Singour ◽  
Shashikant Tiwari ◽  
Vidhu Khare
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Anatomical Variation ◽  
Clinical Importance ◽  
Biliary Tree ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Left Hepatic Duct ◽  
Extrahepatic Biliary Tree ◽  
Insight Into

Background: Congenital anamolies of extrahepatic biliary apparatus and pancreas have long been recognized and are of clinical importance because when present may surprise the surgeon during surgery and lead to iatrogenic injuries. Surgeries on extra-hepatic biliary apparatus and pancreas are regularly performed throughout the world. Thus insight into the normal anatomy and congenital variations will reduce complication and definitely improve outcome.Methods: Study was conducted in department of surgery GMC Bhopal and dissection was carried out in Department of Forensic Medicine on 100 cadavers with approval from ethical committee.Results: In 100 cases 70 were male and 30 female. The most common variation in extra hepatic biliary apparatus was short cystic duct was found in 6% cases then formation of common hepatic duct by union of right hepatic duct and left hepatic duct was intrahepatic in 3% cases. There was low insertion of cystic duct with common hepatic duct in 1% case. Cystic artery originating from left hepatic artery in 1% case, in 1% case cystic artery was anterior to common hepatic duct. In Pancreas anterior arterial arcade was absent in 2% cases and its origin varied in 2% case. Posterior pancreatic arcade absent in 1% cases and variation in origin was present in 1% case. The variation in pancreatic duct course was present in 22% cases.Conclusions: Thus significant variation was seen and it could definitely be helpful to hepatobiliary, laproscopic surgeons, radiologist and will further contribute to literature on variation of extrahepatic biliary apparatus and pancreas and its related vessels.

scholarly journals Mirizzi syndrome complicated by common hepatic duct fistula and left hepatic atrophy: a case report

2018 ◽  
Vol 46 (11) ◽  
pp. 4806-4812 ◽  
Author(s):  
Jiang Zhou ◽  
Rui Xiao ◽  
Jing-rui Yang ◽  
Lu Wang ◽  
Jia-xing Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hepatic Duct ◽  
Rare Complication ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Mirizzi Syndrome ◽  
Fistula Formation ◽  
Common Hepatic Duct ◽  
Asian Woman ◽  
Calot’S Triangle ◽  
Hepatic Atrophy

Background Mirizzi syndrome is a rare complication of chronic cholecystitis, usually caused by gallstones impacted in the cystic duct or the neck of the gallbladder. Mirizzi syndrome results in compression of the hepatic duct or fistula formation between the gallbladder and common bile duct (or hepatic duct, right hepatic duct, or even mutative right posterior hepatic duct). Clinical features include abdominal pain, fever, and obstructive jaundice. Severe inflammation and adhesion at Calot’s triangle are potentially very dangerous for patients with Mirizzi syndrome undergoing cholecystectomy. Case presentation: We report the case of a 68-year-old Asian woman who presented with abdominal pain and jaundice. She had a medical history of gallstones, but no fever. Magnetic resonance cholangiopancreatography revealed cholecystitis, cholelithiasis, common hepatic duct stones, and ascites. Findings at surgery included a porcelainized, atrophic gallbladder that was full of gallstones, fistula formation between the gallbladder and common hepatic duct, and left hepatic atrophy. The prominent feature was the left hepatic atrophy, but stones were not visible pre-operatively in the left liver by radiologic examination. Conclusions This patient exhibited what can be considered a special type II of Mirizzi syndrome with a fistula of the common hepatic duct as well as left hepatic atrophy.

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