J Minim Invasive Surg.  2023 Mar;26(1):35-39. 10.7602/jmis.2023.26.1.35.

Mirizzi syndrome complicated by type IV cholecystobiliary fistula to the right hepatic duct

• Stuart CM
• Huey MG
• Ghincea CV
• Pieracci FM
• Brooke M

• KMID: 2540469
• DOI: http://doi.org/10.7602/jmis.2023.26.1.35

Abstract

Mirizzi syndrome is a rare complication of long-term chronic cholecystitis, characterized by extrinsic compression of the common hepatic duct that may progress to development of cholecystobiliary fistula.Here we report a case of a 38-year-old female patient who underwent laparoscopic cholecystectomy with intraoperative cholangiogram for acute cholecystitis and choledocholithiasis. Intraoperatively, the patient was found to have a Mirizzi syndrome complicated by cholecystobiliary fistula to the right hepatic duct. The gallbladder was successfully removed, cholelithiasis cleared and a ureteral stent was used in reconstruction. The patient was discharged on postoperative two and was doing well on routine follow-up. Ultimately, Mirizzi syndrome is a rare clinical entity that requires careful consideration during preoperative workup and a high suspicion when abnormal anatomy is encountered intraoperatively.

Keyword

Acute cholecystitis; Choledocholithiasis; Intraoperative cholangiogram; Laparoscopic ultrasound