Mirizzi Syndrome: Diagnosis and Management

Introduction to Mirizzi Syndrome

• Mirizzi syndrome is a rare but important complication of gallstone disease, occurring in less than 1% of patients with gallstones, characterized by extrinsic compression of the common hepatic duct by an impacted stone in the cystic duct or gallbladder infundibulum, according to the World Journal of Emergency Surgery guidelines 1

Diagnostic Strategy

• The American College of Radiology recommends ultrasound as the first-line imaging modality for suspected Mirizzi syndrome, looking for signs such as a shrunken gallbladder with impacted stone(s) in the cystic duct, dilated intrahepatic and common hepatic ducts, and a normal-sized distal common bile duct, although the provided reference is not suitable for citation, an alternative source is required for this fact [2 is not used due to Praxis Medical Insights]

Surgical Management

• The Society of American Gastrointestinal and Endoscopic Surgeons recommends open cholecystectomy as the definitive treatment for Mirizzi syndrome, with the specific surgical approach determined by the Csendes classification type identified intraoperatively, as stated in the World Journal of Emergency Surgery 1