Mirizzi syndrome: Mastering the challenge, characterization and management outcomes in a retrospective study of 60 cases

<h3>Background</h3><p dir="ltr">Mirizzi Syndrome (MS) is a rare complication of gallstone disease that poses diagnostic and management challenges.</p><h3>Methods</h3><p dir="ltr">This retrospective study aimed to review our institutional experience in diagnosing and managing MS over seven years and four months.</p><h3>Results</h3><p dir="ltr">Among 8200 cholecystectomies, 60 cases of MS were identified, with type 1 being the most prevalent (90%). The mean age of the patients was 44 years, with male predominance (75%). Southeast Asians comprised 56.7% of the study population. The most common presenting symptom was right upper quadrant pain, and 58.3% of the patients were diagnosed with acute cholangitis. Liver enzyme and bilirubin levels were significantly higher in the advanced types. Preoperative diagnosis was achieved in 70% of patients, with MRCP and ERCP being the most effective diagnostic tools. Laparoscopic cholecystectomy was the most common surgical approach (76.7%), particularly in type 1 (79.6%), and decreased to 50% in advanced types. Hepaticojejunostomy was more common in the advanced types.</p><h3>Conclusion</h3><p dir="ltr">This study highlights the importance of early diagnosis and appropriate management of MS considering its rarity and potential complications. The laparoscopic approach is reasonable, especially for type 1 MS and noncomplicated cases. Further research is needed to optimize treatment strategies for this challenging condition.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Surgery<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpsurg.2024.101626" target="_blank">https://dx.doi.org/10.1016/j.cpsurg.2024.101626</a></p>