Surgical outcome of Mirizzi syndrome: Value of endoscopic retrograde cholangiopancreatography and laparoscopic procedures

Chun Nan Yeh, Shang Yu Wang, Keng Hao Liu, Ta Sen Yeh, Chun Yi Tsai, Jeng Hwei Tseng, Chi Huan Wu, Nai Jen Liu, Yin Yi Chu, Yi Yin Jan*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


Background: Laparoscopic cholecystectomy (LC) with associated procedures and endoscopic retrograde cholangiopancreatography (ERCP) have been the standard treatments for both common and rare biliary diseases. Mirizzi syndrome (MS) is a rare and complex biliary condition. We report our experience with MS treatment and investigate the value of laparoscopic procedures and ERCP in patient management. Methods: From 2004 to 2017, 100 consecutive patients with MS were diagnosed by ERCP and underwent surgery in a referral center. Sixty patients were treated with intended LC, and 40 patients were treated with open cholecystectomy (OC). The clinical manifestations, ERCP and associated procedures, surgical procedures, and postoperative outcomes were investigated. Results: The surgical mortality rate was 1%, while the surgical morbidity rate was 15%. The patients treated with intended LC suffered from less morbidity (5%). The percentage of postoperative residual biliary stones was 32% (n = 32), and only three patients underwent re-operation (laparotomy) for stone removal. The laparotomy conversion rate in the intended LC group was 16.7% (10/60). The length of hospitalization for the patients with successful LC was significantly shorter than that for the patients with conversion and intended OC. Csendes classification was a risk factor for conversion from LC to OC (type I vs types II to V, P <.0001). Conclusions: A combination of a laparoscopic procedure and ERCP may provide therapeutic benefits for patients with MS.

Original languageEnglish
Pages (from-to)760-769
Number of pages10
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number9
StatePublished - 09 2021

Bibliographical note

Publisher Copyright:
© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery


  • Mirizzi syndrome
  • biliary disease
  • cystic duct anomaly
  • endoscopic retrograde cholangiopancreatography
  • laparoscopic cholecystectomy


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