Mirizzi syndrome complicated by type IV cholecystobiliary fistula to the right hepatic duct

Christina M Stuart; Madeline G Huey; Christian V Ghincea; Fredric M Pieracci; Magdalene Brooke

doi:10.7602/jmis.2023.26.1.35

Mirizzi syndrome complicated by type IV cholecystobiliary fistula to the right hepatic duct

J Minim Invasive Surg. 2023 Mar 15;26(1):35-39. doi: 10.7602/jmis.2023.26.1.35.

Authors

Christina M Stuart¹, Madeline G Huey¹, Christian V Ghincea¹, Fredric M Pieracci², Magdalene Brooke²

Affiliations

¹ Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
² Department of Surgery, Denver Health, Denver, CO, USA.

Abstract

Mirizzi syndrome is a rare complication of long-term chronic cholecystitis, characterized by extrinsic compression of the common hepatic duct that may progress to development of cholecystobiliary fistula. Here we report a case of a 38-year-old female patient who underwent laparoscopic cholecystectomy with intraoperative cholangiogram for acute cholecystitis and choledocholithiasis. Intraoperatively, the patient was found to have a Mirizzi syndrome complicated by cholecystobiliary fistula to the right hepatic duct. The gallbladder was successfully removed, cholelithiasis cleared and a ureteral stent was used in reconstruction. The patient was discharged on postoperative two and was doing well on routine follow-up. Ultimately, Mirizzi syndrome is a rare clinical entity that requires careful consideration during preoperative workup and a high suspicion when abnormal anatomy is encountered intraoperatively.

Keywords: Acute cholecystitis; Choledocholithiasis; Intraoperative cholangiogram; Laparoscopic ultrasound.

Publication types

Case Reports