Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome
Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Miri...
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Wiley
2017-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/1710501 |
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| author | Jason Deforest Jones Rishi Pawa |
| author_facet | Jason Deforest Jones Rishi Pawa |
| author_sort | Jason Deforest Jones |
| collection | DOAJ |
| description | Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy. |
| format | Article |
| id | doaj-art-d5fdbea0eaba4954aedb085b04598e96 |
| institution | DOAJ |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-d5fdbea0eaba4954aedb085b04598e962025-08-20T03:23:38ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362017-01-01201710.1155/2017/17105011710501Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi SyndromeJason Deforest Jones0Rishi Pawa1Division of Gastroenterology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USADivision of Gastroenterology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USAMirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.http://dx.doi.org/10.1155/2017/1710501 |
| spellingShingle | Jason Deforest Jones Rishi Pawa Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome Case Reports in Gastrointestinal Medicine |
| title | Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome |
| title_full | Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome |
| title_fullStr | Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome |
| title_full_unstemmed | Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome |
| title_short | Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome |
| title_sort | single operator peroral cholangioscopy for extraction of cystic duct stones in postcholecystectomy mirizzi syndrome |
| url | http://dx.doi.org/10.1155/2017/1710501 |
| work_keys_str_mv | AT jasondeforestjones singleoperatorperoralcholangioscopyforextractionofcysticductstonesinpostcholecystectomymirizzisyndrome AT rishipawa singleoperatorperoralcholangioscopyforextractionofcysticductstonesinpostcholecystectomymirizzisyndrome |