Study data from M.D. Kelly and co-authors update knowledge of mirizzi syndrome
2009 JUN 8 - (NewsRx.com) -- "Mirizzi syndrome is a rare complication of cholecystolithiasis characterized by jaundice due to compression of the common hepatic duct. The diagnosis may not be immediately apparent, and management is controversial with open surgery still recommended by some authors," scientists writing in the Jsls - Journal of the Society of Laparoendoscopic Surgeons report. "A case is detailed herein of a 67-year-old man who presented with abdominal pain, fever, and jaundice. A dilated bile duct eras found on ultrasound, but the gallbladder could not be seen. The diagnosis of Mirizzi syndrome was made at ERCP, and a stent was placed through the papilla. Laparoscopic retrograde (fundus first) cholecystectomy was carried out utilizing a laparoscopic liver retractor. In this particular case, it was not possible at FRCP to get a guidewire and stent past the obstruction. A stent was left through the papilla, below the obstruction and this allowed primary duct closure during surgery. Acute Mirizzi syndrome should be suspected when a patient presents with acute cholecystitis and jaundice with dilated intrahepatic ducts on ultrasound. FRCP is useful to confirm the diagnosis and allows stenting to alleviate the jaundice and facilitate the subsequent operation," wrote M.D. Kelly and colleagues. The researchers concluded: "Laparoscopic ultrasound is useful to locate the impacted stone and to partially replicate the touch of the surgeon's hand, which is not available in laparoscopic surgery." Kelly and colleagues published their study in Jsls - Journal of the Society of Laparoendoscopic Surgeons (Acute Mirizzi Syndrome. Jsls - Journal of the Society of Laparoendoscopic Surgeons, 2009;13(1):104-109). Additional information can be obtained by contacting M.D. Kelly, Frenchay Hospital, Dept. of Upper GI Surgery, Bristol BS16 1LE, Avon, UK. The publisher of the Jsls - Journal of the Society of Laparoendoscopic Surgeons can be contacted at: Society Laparoendoscopic Surgeons, 7330 SW 62 Pl, Ste. 410, Miami, FL 33143-4825, USA. Keywords: United Kingdom, Bristol, Abdominal Pain, Cholecystolithiasis, Gallbladder, Gastroenterology, Jaundice, Laparoscopic Cholecystectomy, Mirizzi syndrome, Surgery. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.
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