Slovenská chirurgia 2e/2026
Mirizzi syndrome: 5 years of experience at the HPB clinic
Introduction: Mirizzi syndrome (MS) is a rare complication of cholecystolithiasis, resulting in obstruction of the hepatocholedochal duct by mechanical obstruction or inflammation due to a calculus lodged in the Hartemann‘s loop or in the cystic duct. Its manifestation during cholecystectomies ranges between 0.3-5%.
Material and methods: This is a retrospective study aimed at providing our experience with the treatment of MS. Data for the period from March 2020 to June 2025 were obtained from the hospital database, which we subsequently processed.
Results: Out of a total of 375 cholecystectomies performed, we identified 12 cases of MS. The most common accompanying symptom was right upper quadrant pain (RUQ), which affected 83.3% of patients. This was followed by jaundice, fever, nausea and vomiting. The most common variant of MS was I. and II. grade, which we recorded equally in 33.3% of cases. 7 patients underwent cholecystectomy, but in 5 we had to require biliodigestive anastomosis. In the diagnosis, USG was the method of choice in all cases, followed by ERCP (83.3%), CT (75%) and MRCP (33.3%). The rate of preoperative diagnosis of MS was 41.5%.
Conclusion: The incidence of MS is very low, not considering the complexity of the problem, which the patient should be centralized with suspicion of this, since it is necessary to first assume the correct treatment of biliodigestive anastomosis.
Keywords: Mirizzi syndrome, biliodigestive anastomosis, hepaticojejunostomy, cholecystectomy
