CURRENT TRENDS IN THE MANAGEMENT OF MIRIZZI SYNDROME

Dr. Brijesh Parekh; Dr. Aakash Rathod; Dr. Bijal Prajapati; Dr. Vaibhav Patel; Dr. Pooja Shah

Volume : IX, Issue : VII, July - 2020

CURRENT TRENDS IN THE MANAGEMENT OF MIRIZZI SYNDROME

Dr. Brijesh Parekh, Dr. Aakash Rathod, Dr. Bijal Prajapati, Dr. Vaibhav Patel, Dr. Pooja Shah

Abstract :

Mirizzi Syndrome is a rare and challenging clinical entity to manage. However, recent advances in technology have provided surgeons with new options for more effective diagnosis and treatment of this condition. This article reviews these new diagnostic modalities and treatment approaches for the management of Mirizzi Syndrome. This study was done on patients admitted in L.G. Hospital surgical wards, Ahmedabad with diagnosis of acute cholecystitis and cholelithiasis from 2018 to 2020. An active search of Mirizzi Syndrome in those patients was done by using further diagnostic techniques. In total 10 cases, 7 case reports were identified and analysed. The most frequently used diagnostic modalities were ultrasound, computed tomography (CT); magnetic resonance cholangiopancreatography (MRCP); endoscopic retrograde cholangiopancreatography (ERCP). A combination of >2 diagnostic modalities was frequently used to detect Mirizzi Syndrome. Article shows that the specific type of Mirizzi Syndrome determined the type of treatment chosen. Open surgery was the preferred option, although there are documented cases of the use of minimally invasive techniques, even in advanced cases. Laparoscopic, endoscopic or robot assisted surgery, used individually or in combination with lithotripsy, ere all associated with a favourable outcome. As yet, there are no internationally accepted guidelines for the management of Mirizzi Syndrome. Laparotomy is the preferred surgical technique of choice, although an increasing number of surgeons are beginning to opt for minimally invasive techniques. The number of papers in the existing article describing diagnostic and treatment procedures is relatively small at present, thus making it difficult to reasonably propose an evidence based standard of care for Mirizzi Syndrome.