Laparoscopic subtotal cholecystectomy for Mirizzi syndrome: A report of a case. (2019) - Kimura, Jiro
Highlights: Laparoscopic subtotal cholecystectomy was successfully performed for a patient. The rates of bile duct injuries is high after laparoscopic cholecystectomy. Removal of the stone is the main purpose of treatment. Laparoscopic subtotal cholecystectomy is useful for patients with Mirizzi syndrome. Abstract: Introduction: Mirizzi syndrome is a rare complication of gallstone disease. The purpose of this report is to describe the utility of laparoscopic subtotal cholecystectomy for Mirizzi syndrome. Presentation of case: A 53-year-old female presented with dark urine and right upper quadrant pain. Blood tests revealed elevated liver and biliary enzyme levels. Magnetic resonance cholangiopancreatography showed a narrowed common hepatic duct compressed by a large gallstone, consistent with Mirizzi syndrome. Semi-urgent laparoscopic cholecystectomy was planned. At operation, circumferential dissection of the gallbladder neck was difficult. The fundus of the gallbladder was opened and a 2 cm stone extracted. The gallbladder neck was sutured and a drain placed. The postoperative clinical course was uneventful. Discussion: After laparoscopic cholecystectomy in patients with Mirizzi syndrome, complication rates, including bile duct injuries, is high. In patients with Mirizzi syndrome, removal of the responsible stone is the main purpose of treatment. Conclusion: Laparoscopic subtotal cholecystectomy is a useful technique for patients with Mirizzi syndrome to avoid bile duct injury.