Korean J Hepatobiliary Pancreat Surg.  2013 May;17(2):79-82. 10.14701/kjhbps.2013.17.2.79.

Laparoscopic treatment for post-cholecystectomy Mirizzi syndrome

• Lim MS
• Jeon JY
• Kwon JW
• Kim IG
• Cho JW
• Kim JH
• Ha HI
• Kim JS

• KMID: 1429984
• DOI: http://doi.org/10.14701/kjhbps.2013.17.2.79

Abstract

The remnant cystic duct or gallbladder neck calculus may rarely result in post-cholecystectomy Mirizzi syndrome. Various managements have been proposed for the treatment of post-cholecystectomy Mirizzi syndrome. Some previous cases of post-cholecystectomy Mirizzi syndrome have been managed with open cholecystectomy and endoscopically. We report a case of a laparoscopic stone removal of post-cholecystectomy Mirizzi syndrome that developed 7 months after laparoscopic cholecystectomy. To our knowledge, this is the first case of laparoscopic management of post-cholecystectomy Mirizzi syndrome. The mechanism, diagnosis and treatment of post-cholecystectomy Mirizzi syndrome are discussed.

Keyword

Mirizzi syndrome; Cholecystectomy; Gallstone

MeSH Terms

Calculi
Cholecystectomy
Cholecystectomy, Laparoscopic
Cystic Duct
Gallbladder
Gallstones
Mirizzi Syndrome
Neck

Figure

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  Fig. 1 Coronal T2-weighted image shows a cystic duct stone representing as dark signal intensity round lesion (arrows) and shows remnant cystic duct appearing tubular hyperintense lesion (arrowhead).

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  Fig. 2 An ovoid filling defect is noted in mid CBD level, which resulted in mild dilatation of above the common hepatic duct and intrahepatic bile ducts.

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  Fig. 3 An 1.2 cm-sized high density stone (arrow) is abutting the ENBD tube (arrowhead), posteriorly.

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  Fig. 4 Gallstone removal after incision of the wall of the remnant cystic duct.

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  Fig. 5 Intraoperative cholangiography showing no stenosis of the common bile duct and no bile leakage.

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