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Case Rep Radiol 2020 27;2020:2049525. Epub 2020 Jan 27.

Department of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, Japan.

Despite a considerable number of reports of Mirizzi syndrome, none have described the process of its development from simple cholecystolithiasis. We report an extremely rare case of Mirizzi syndrome in which it was possible to observe the process of development of cholecystobiliary fistula from asymptomatic cholecystolithiasis until unavoidable surgical intervention 4 years later. A 68-year-old woman presented at our hospital with right upper quadrant pain. Read More

Clin Imaging 2020 Apr 28;60(2):228-236. Epub 2019 Nov 28.

Department of Diagnostic Radiology, Bridgeport Hospital at Yale New Haven Health, 167 Grant St, Bridgeport, CT 06610, USA.

Gallstone disease is the term commonly used to refer to gallstones that cause symptoms. There is a myriad of complications that can arise from gallstones: acute cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder wall perforations, pericholecystic abscesses, Mirizzi syndrome, cholecystoenteric fistulas, choledocholithiasis, gallstone pancreatitis, porcelain gallbladder, gallbladder malignancies, and many more. The aim of this pictorial review is to revisit how multimodality imaging can help with the diagnosis of gallstone disease. Read More

Int J Surg Case Rep 2019 24;63:97-100. Epub 2019 Sep 24.

Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.

Introduction: Mirizzi syndrome is a rare complication of gallstone disease that more rarely is associated with the formation of cholecystoenteric fistula.

Presentation Of Case: The patient presented with a five-day history of abdominal pain in the right upper quadrant (RUQ), nausea, and emesis. Further ultrasound (US) imaging demonstrated a large gallstone with associated thickened gallbladder with pericholecystic fluid. Read More

Arch Med Sci 2019 Sep 10;15(5):1288-1293. Epub 2019 Aug 10.

Department of Radiology, the Second People's Hospital of Wuxi, Wuxi, Jiangsu, China.

Introduction: The aim was to evaluate the diagnostic value of the Nakagawa and Csendes pathology classification systems in preoperative imaging of Mirizzi syndrome. Mirizzi syndrome is a type of biliary system obstruction caused by stones impacted in a gallbladder neck or cystic duct situated parallel to the common bile duct, causing extrinsic common bile duct stenosis or obstruction, which can lead to recurrent obstructive jaundice, bile duct erosion, and cholangitis. Therefore, the preoperative identification and classification of Mirizzi syndrome is vital for a good surgical result. Read More

G Chir 2019 May-Jun;40(3):193-198

Mirizzi Syndrome (MS) is an uncommon complication of chronic gallstone disease defined as a common bile duct (CBD) obstruction secondary to gallstone impaction in the cystic duct or gallbladder neck. MS is still a challenging clinical situation: preoperative diagnosis of MS is complex and can be made in 18-62.5% of patients. Read More

BMJ Case Rep 2019 Aug 5;12(8). Epub 2019 Aug 5.

Department of Gastrointestinal Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.

Postcholecystectomy Mirizzi syndrome (PCMS) is an uncommon entity that can occur due to cystic duct stump calculus, gall bladder remnant calculus or migrated surgical clip. It can be classified into early PCMS or late PCMS. It is often misdiagnosed and the management depends on the site of impaction of stone or clip. Read More

Khirurgiia (Mosk) 2019 (3):42-47

Martynov Chair of Hospital-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of Russia Moscow, Russia, Vorokhobov Munitsipal Clinical Hospital #67 of Moscow Healthcare Department, Moscow, Russia.

Aim: To assess an effectiveness of complex preoperative diagnosis, conservative treatment, minimally invasive biliary decompression for Mirizzi syndrome and to analyze surgical outcomes depending on the effectiveness of minimally invasive biliary decompression.

Material And Methods: There were 67 patients with Mirizzi syndrome aged 27-96 years (mean age -64.8 years). Read More

Am J Case Rep 2019 Mar 26;20:394-397. Epub 2019 Mar 26.

Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA.

BACKGROUND Mirizzi syndrome is an uncommon but clinically important complication of gallbladder disease that occurs when there is extrinsic compression of the common hepatic duct from gallstones within the cystic duct or from within the gallbladder itself. Obstructive jaundice and cholangitis may ensue. In severe cases, bile duct erosion or gallbladder rupture occur. Read More

J Gastrointestin Liver Dis 2019 Mar;28(1)

Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital;Humanitas University, Rozzano, Milan, Italy.

Radiologe 2019 Apr;59(4):328-337

Radiologie, KFJ Spital, Wien, Österreich.

Clinical Issue: Due to the high prevalence of clinically suspected cholecystitis or cholecystolithiasis the gallbladder is one of the organs examined the most by imaging.

Standard Radiological Methods: In most clinical settings ultrasound is the primary imaging method because of its wide availability, speed and superior spatial resolution. In cases of ambiguous findings or potential complications computed tomography (CT) and magnetic resonance imaging (MRI) are used. Read More

Asian J Endosc Surg 2019 Apr 13;12(2):227-231. Epub 2018 Dec 13.

Division of Surgery, Gastroenterological Center, Medico Shunju Shiroyama Hospital, Osaka, Japan.

Introduction: A 50-year-old Japanese man presented with obstructive jaundice. We performed endoscopic retrograde biliary drainage before biliary decompression. CT showed a thickened gallbladder wall with low-density areas and a 35-mm gallstone; the stone was impacted in the gallbladder neck and cystic duct. Read More

Rev Esp Enferm Dig 2019 Feb;111(2):121-128

Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki , Gre.

Background and study purpose: Hilar cholangiocarcinoma, also known as Altemeier-Klatskin tumor, is a rare malignancy that arises in the confluence of the hepatic ducts of the porta hepatis. The prognosis is rather poor. Several lesions mimic these tumors and lead to a misdiagnosis, resulting in radical hepatic resections. Read More

J Int Med Res 2018 Nov 23;46(11):4806-4812. Epub 2018 Sep 23.

1 Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China PR.

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. Read More

J Gastrointest Cancer 2019 Dec;50(4):997-1000

Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Basni Industrial Area, Phase-II, Jodhpur, Rajasthan, 342005, India.

Can J Gastroenterol Hepatol 2018 12;2018:6962090. Epub 2018 Aug 12.

Department of Surgical Sciences, Hepatobiliary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Hearth, Rome, Italy.

Background: Mirizzi syndrome is a condition difficult to diagnose and treat, representing a particular "challenge" for the biliary surgeon. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. Furthermore, it increases the risk of intraoperative biliary injury during cholecystectomy. Read More

Am J Med Sci 2018 10 4;356(4):e33. Epub 2018 May 4.

Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, Connecticut.

Saudi J Gastroenterol 2018 Sep-Oct;24(5):274-281

Department of Surgical Gastroenterology, Jagjivanram Western Railway Hospital, Mumbai, Maharashtra, India.

Background/aim: Mirizzi's syndrome (MS) is an unusual complication of gallstone disease and occurs in approximately 1% of patients with cholelithiasis. Majority of cases are not identified preoperatively, despite the availability of modern imaging techniques. A preoperative diagnosis can forewarn the operating surgeon and avoid bile duct injuries in cases of complicated cholecystitis. Read More

BMJ Case Rep 2018 Apr 13;2018. Epub 2018 Apr 13.

Department of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.

We present the case of a young female with symptoms of biliary colic and a biochemical profile consistent with biliary obstruction. Imaging was suspicious for Mirizzi's syndrome. Intraoperatively, the patient was found to have a complete intrahepatic gallbladder causing common hepatic duct compression with final pathology confirming acute cholecystitis. Read More

Dig Surg 2018 30;35(6):491-497. Epub 2017 Nov 30.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore.

Background: Mirizzi syndrome (MS) occurs when gallstone impaction in Hartmann's pouch results in extrinsic obstruction of the common bile duct, and fistulation may occur.

Methods: We retrospectively reviewed electronic records of patients surgically treated for MS from November 2001 to June 2012. Patient presentations, diagnostic methods, treatments and complications were recorded. Read More

Pan Afr Med J 2017 18;27:45. Epub 2017 May 18.

²Service des urgences médico-chirurgicales, Hôpital Militaire Mohamed V, Faculté de médecine et de pharmacie, Rabat, Maroc.

Mirizzi's syndrome is a rare complication of chronic vesicular lithiasis with prevalence ranging from 0.7% to 1.4% among patients who have undergone cholecystectomy. Read More

J Gastroenterol Hepatol 2018 Feb;33(2):335

Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

J Gastrointest Surg 2017 Sep 10;21(9):1540-1543. Epub 2017 Jul 10.

Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Bd du Général Leclerc, 92110, Clichy, France.

Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. Read More

Dig Dis Sci 2017 Dec 28;62(12):3317-3320. Epub 2017 Apr 28.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Stanford University School of Medicine, Stanford, CA, USA.

J Gastroenterol 2017 Mar 10;52(3):276-300. Epub 2016 Dec 10.

, Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.

Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Read More

Semin Intervent Radiol 2016 Dec;33(4):332-336

Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois.

Biliary obstruction occurs in a wide variety of malignant and benign conditions. The following is a unique case of biliary obstruction caused by external compression of the hepatic duct by a gallstone (Mirizzi syndrome). Owing to unusual imaging characteristics of the stone, the mass was initially mistaken for a malignancy or hepatic pseudoaneurysm. Read More

Gastroenterol Hepatol 2016 Nov 3;39(9):599-600. Epub 2015 Nov 3.

Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España.

Vestn Rentgenol Radiol 2016 Sep-Oct;97(5):261-7

Objective: To improve the results of preoperative diagnosis of Mirizzi syndrome.

Material And Methods: Under our supervision for 2006–2015 we had 23 patients with the Mirizzi syndrome. Verification of cholecystolithiasis, condition of gallbladder’s wall and biliary tract dilatation degree was evaluated sonographically. Read More

J Med Case Rep 2016 May 27;10:135. Epub 2016 May 27.

Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece.

Background: Laparoscopic cholecystectomy is the gold standard treatment of gallbladder disease. Post-cholecystectomy syndrome is a severe postoperative complication which can be caused by multiple mechanisms and can present with multiple disorders. The wide use of laparoscopy induces the need to understand more clearly the presentation and pathophysiology of this syndrome. Read More

Case Rep Surg 2016 15;2016:1030358. Epub 2016 May 15.

General Surgery Department, Private Minasera Aldan Hospital, 06810 Ankara, Turkey.

Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann's pouch that mechanically obstructs the common bile duct. We would like to report laparoscopic treatment of type III MS. A 75-year-old man was admitted with the complaint of abdominal pain and jaundice. Read More

Am J Gastroenterol 2016 05;111(5):599

National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Korean J Hepatobiliary Pancreat Surg 2016 Feb 19;20(1):17-22. Epub 2016 Feb 19.

Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Backgrounds/aims: Mirizzi's syndrome (MS) poses great diagnostic and management challenge to the treating physician. We presented our experience of MS cases with respect to clinical presentation, diagnostic difficulties, surgical procedures and outcome.

Methods: Prospectively maintained data of all surgically treated MS patients were analyzed. Read More

Int J Surg Case Rep 2016 6;21:12-5. Epub 2016 Feb 6.

Eastern Health Surgical Research Group, Monash University, Eastern Health Clinical School, 5 Arnold St, Box Hill, Melbourne, Victoria 3128, Australia. Electronic address:

Introduction: Gastrointestinal bleeding can have significant morbidity and mortality. Pathological processes that cause it are diverse, and timely investigation and management are vital. Dieulafoy lesions are a rare cause of gastrointestinal bleeding and here we describe a case of a gallbladder dieulafoy lesion causing gastrointestinal bleeding. Read More

BMJ Case Rep 2016 Jan 11;2016. Epub 2016 Jan 11.

King Saud University, Riyadh, Saudi Arabia.

A woman in her mid-30s presented with upper right quadrant abdominal pain. On examination, there was mild upper right quadrant tenderness and negative Murphy's sign. Basic laboratory investigations revealed normal results except for elevated alkaline phosphatase. Read More

Klin Khir 2016(9):25-7

Results of diagnosis and treatment of 21 patients, suffering Mirizzi syndrome (MS), were analyzed. Informativity of ultrasound investigation and endoscopic retrograde cholangiopancreatography in diagnosis of MS types I and II was presented. The first stage of treatment consisted of endoscopic interventions — lithotripsy with lithoextraction, the biliary ducts stenting, nasobiliary drainage. Read More

Hiroshima J Med Sci 2015 Sep;64(3):45-9

Mirizzi syndrome is a rare complication of cholelithiasis, which is defined as a common bile duct obstruction due to stones impacted in Hartman's pouch or the cystic duct of the gallbladder. The impacted stones and surrounding inflammation can lead to a biliobiliary fistula. We herein present the case of a 73-year-old Japanese man with a biliobiliary fistula that was diagnosed by peroral cholangiography (POCS). Read More

Gastrointest Endosc 2016 May 30;83(5):1034. Epub 2015 Oct 30.

Brigham and Women's Hospital, Boston, Massachusetts, USA.

Case Rep Pancreat Cancer 2015 1;1(1):16-21. Epub 2015 Nov 1.

Department of Surgery, The Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania.

Correct preoperative diagnosis of hepatobiliary disease can be challenging-even with current advances in radiographical imaging, laboratory testing, and endoscopic evaluation. A 65-year-old female with painless jaundice and weight loss was found to have cholelithiasis complicated by the Mirizzi syndrome. A 71-year-old female with new-onset painless jaundice and impacted stone in the gallbladder neck was found to have a cholangiocarcinoma. Read More

Gastrointest Endosc 2016 Mar 28;83(3):668; discussion 668-9. Epub 2015 Sep 28.

Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA.

Singapore Med J 2015 Aug;56(8):438-43; quiz 444

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

Acute cholecystitis is a common cause of right upper quadrant pain in patients presenting at the emergency department. Early diagnosis and recognition of associated complications, though challenging, are essential for timely management. Imaging studies, including ultrasonography, computed tomography and magnetic resonance imaging, are increasingly utilised for the evaluation of suspected cases of cholecystitis. Read More

Eksp Klin Gastroenterol 2015 (11):77-81

Analysis of the possibilities of application of minimally invasive approaches in Mirizzi syndrome. Analyzed the treatment of 70 patients with the syndrome Mirizzi treated from 2002 to 2012. The study describes the features of the application of minimally invasive interventions in Mirizzi syndrome. Read More

Rev Port Cardiol 2014 Dec 11;33(12):807-9. Epub 2014 Nov 11.

Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy.

Quant Imaging Med Surg 2014 Jun;4(3):212-3

Dokuz Eylül University, Department of Radiology, Izmir, Turkey.

Gallstone disease is common. However, a proportion of patients are asymptomatic and remain undiagnosed until the occurrence of complications. Common complications include acute cholecystitis, biliary obstruction, acute pancreatitis and cholangitis. Read More

Radiographics 2014 May-Jun;34(3):565-86

From the Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Tex (V.S.K.); and Department of Radiology, University of Pittsburgh Medical Center, Presby South Tower, Suite 4895, 200 Lothrop St, Pittsburgh, PA 15213 (A.K.D., N.D., K.H.).

Bile duct strictures in adults are secondary to a wide spectrum of benign and malignant pathologic conditions. Benign causes of bile duct strictures include iatrogenic causes, acute or chronic pancreatitis, choledocholithiasis, primary sclerosing cholangitis, IgG4-related sclerosing cholangitis, liver transplantation, recurrent pyogenic cholangitis, Mirizzi syndrome, acquired immunodeficiency syndrome cholangiopathy, and sphincter of Oddi dysfunction. Malignant causes include cholangiocarcinoma, pancreatic adenocarcinoma, and periampullary carcinomas. Read More

Clin J Gastroenterol 2013 Dec 5;6(6):490-5. Epub 2013 Nov 5.

Asahikawa City Hospital, 1-65, Kinseicho 1-chome, Asahikawa, Hokkaido, Japan.

Pseudoaneurysm of the cystic artery is a rare complication of cholecystitis. 34 cases have been reported from 1976 to 2012, searched on MEDLINE and most of the cases have presented with gastrointestinal bleeding. We report the third case of an unruptured pseudoaneurysm of the cystic artery associated with calculous cholecystitis. Read More

Radiographics 2013 Nov-Dec;33(7):1867-88

From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637.

Various biliary pathologic conditions can lead to acute abdominal pain. Specific diagnosis is not always possible clinically because many biliary diseases have overlapping signs and symptoms. Imaging can help narrow the differential diagnosis and lead to a specific diagnosis. Read More

Chin Med J (Engl) 2013 ;126(18):3515-8

Department of General Surgery, First Hospital of Lanzhou University, the First Clinical Medical School of Lanzhou University, anzhou, Gansu 730000, China.

Background: Mirizzi syndrome is often difficult to diagnose before surgery, and is often accompanied by extensive adhesions in the cystohepatic (Calot's) triangle and the difficulty of separating tissue can lead to bile duct injury and other intraoperative and postoperative complications. The aim of this study is to investigate minimally invasive means of treating different types of Mirizzi syndrome.

Methods: Fifty-four patients diagnosed with Mirizzi syndrome were enrolled between July 2004 and May 2012. Read More

J Coll Physicians Surg Pak 2013 Jul;23(7):504-6

Department of Radiology, The Aga Khan University Hospital, Karachi.

Acute cholecystitis leading to development of a pseudoaneurysm of the hepatic artery is a very rare complication; however, a pseudoaneurysm resulting in gallbladder neck compression with dilatation of intrahepatic duct giving a Mirizzi syndrome like presentation is virtually unreported to the best of our knowledge. We report a case of a 60 years male patient who presented in emergency department with right hypochondrial pain and mild jaundice. Initial diagnosis of hepatic artery pseudoaneurysm causing compression of neck of gallbladder and common bile duct was made on ultrasound examination. Read More

Intern Med 2013 ;52(12):1419

Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taiwan.

Cir Cir 2013 May-Jun;81(3):232-6

Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México.

Background: Mirizzi syndrome is a complication of gallbladder stones impacted in Hartmann's pouch or cystic duct with compression of the bile duct. The diagnosis is made by imaging studies, although most of them are found through intraoperative surgical findings. Treatment is cholecystectomy and bile duct restoration when needed. Read More

Surg Laparosc Endosc Percutan Tech 2013 Feb;23(1):e17-21

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China.

Mirizzi syndrome is an uncommon cause of common hepatic duct obstruction resulting from gallstone impaction in the cystic duct or gallbladder neck. Mirizzi syndrome is traditionally considered as a contraindication to laparoscopic surgery mainly due to risk of bile duct injury during dissection. We present the surgical experience of 5 patients with Mirizzi syndrome who were diagnosed preoperatively and managed using minimally access surgical technique, either total laparoscopic or robotic-assisted laparoscopic approach. Read More