Recent Advances in the Management of Mirizzi’s Syndrome: A Review
Kumar H.R. *
Department of Surgery, Taylor’s University School of Medicine and Health Science, 47500 Subang Jaya, Selangor, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Mirizzi's syndrome represents a rare complication of acute cholecystitis, yet it is associated with considerable morbidity. The diagnosis is challenging, with preoperative identification achieved in only 50% of cases due to the non-specific nature of clinical symptoms. Typically, diagnosis is facilitated through endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), as ultrasound and computed tomography exhibit low sensitivity for this condition. The treatment approach for Mirizzi's syndrome is contingent upon its classification. Grades 1 and 2 necessitate a cholecystectomy, grade 3 requires a subtotal cholecystectomy, and grade 4 may necessitate a hepatic-enterostomy or choledochal-enterostomy. This review article has been conducted to examine the diagnostic and management strategies for Mirizzi's syndrome.
Keywords: Mirizzi’s syndrome, obstructive jaundice, subtotal cholecystectomy, endoscopic retrograde cholangiopancreatography, choledochal-enterostomy, gallbladder fistula