The incidence of Mirizzi syndrome in patients undergoing endoscopic retrograde cholangiopancreatography

Background: Mirizzi syndrome is a rare complication of cholelithiasis, characterized by the narrowing of the common hepatic duct as a result of mechanical compression and/or inflammation due to biliary calculus impacted in the infundibula of the gallbladder or in the cystic duct. In this study, we aimed to describe the clinical presentations, investigations, operative details, and complications of seven patients who underwent endoscopic retrograde cholangiopancreatography and were finally diagnosed with Mirizzi syndrome in our center. Method: We performed a retrospective analysis of the records of 7 patients with Mirizzi syndrome who underwent endoscopic retrograde cholangiopancreatography. Results: The incidence of Mirizzi syndrome was 1.07% of 656 patients given endoscopic retrograde cholangiopancreatography. Ultrasonography was able to diagnose one case. Endoscopic retrograde cholangiopancreatography suggested the diagnosis in five cases and helped further in the management of these patients. Four patients had cholecystectomy and T-tube placement, and two had cholecystectomy and choledochoduodenostomy. One patient with type I Mirizzi syndrome according to the Csendes classification successfully underwent laparoscopic cholecystectomy. Conclusions: In the study, the incidence of Mirizzi syndrome was 1.07% of patients who underwent endoscopic retrograde cholangiopancreatography. Preoperative diagnosis of Mirizzi syndrome by endoscopic retrograde cholangiopancreatography is important to prevent complications. © 2008, Hepatobiliary Pancreat Dis Int. All rights reserved