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Cirugía paraguaya

versão On-line ISSN 2307-0420

Resumo

MENDEZ, Elvio  e  SAMANIEGO, Castor. El manejo del síndrome de Mirizzi en un servicio de cirugía general: Mirizzi syndrome management in a department of general surgery. Rev. Cir. Parag. [online]. 2013, vol.37, n.1, pp.10-14. ISSN 2307-0420.

ABSTRACT Background:Mirizzi syndrome is an anatomic disorder of the biliary ducts, at the neck of the cystic duct as a lateconsequence of cholelithiasis. Objective: To determine the clinical presentation of MS, to classify the lesions, and immediate treatment outcomes. Patients and method:This was a descriptive and retrospective study based in 16 patients (14 females and 2 males, with a mean age of 58 years old) who underwent surgical treat- ment during the 2005- 2010 period, in which MS was discovered during surgery. Results: Mean symptoms were abdominal pain and jaundice. Ultrasonography showed cholecystolithiasis in 15 patients (2 of them with acute inflammatory signs) and choledocholithiasis in one patient; diameter of the common bile duct was bigger than 7 mm in 10 patients, in 2 patients the existence of MS was suspected.The lesions were type II in 50% of the patients, whereas type III was found in 12.5% of the patients. Ten total cholecystectomies and six partial cholecystectomies were performed, one of them with reconstruction of the common bile duct, and the other one with closure of the duodenal fistula; besides cholecystectomy, 8 patients , underwent choledochotomy and extraction of the gallstones. Conclusions:Lesions were mailnly type II and III, surgical treatment included cholecystectomy with choledochotomy, closure of the fistula and reconstructions of the biliary duct.

Palavras-chave : Mirizzi syndrome; Reconstruction of the biliary duct; Choledochotomy.

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