Mirizzi syndrome grades III and IV: surgical treatment

Detalhes bibliográficos
Autor(a) principal: REVERDITO,RONALD
Data de Publicação: 2016
Outros Autores: MORICZ,ANDRÉ DE, CAMPOS,TÉRCIO DE, PACHECO JÚNIOR,ADHEMAR MONTEIRO, SILVA,RODRIGO ALTENFELDER
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista do Colégio Brasileiro de Cirurgiões
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912016000400243
Resumo: ABSTRACT Objective : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. Methods : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. Results : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. Conclusion : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity.
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spelling Mirizzi syndrome grades III and IV: surgical treatmentMirizzi Syndrome. JaundiceObstrutive. Epidemiology. Therapeutics. Surgical ProceduresOperative.ABSTRACT Objective : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. Methods : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. Results : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. Conclusion : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity.Colégio Brasileiro de Cirurgiões2016-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912016000400243Revista do Colégio Brasileiro de Cirurgiões v.43 n.4 2016reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-69912016004005info:eu-repo/semantics/openAccessREVERDITO,RONALDMORICZ,ANDRÉ DECAMPOS,TÉRCIO DEPACHECO JÚNIOR,ADHEMAR MONTEIROSILVA,RODRIGO ALTENFELDEReng2016-09-16T00:00:00Zoai:scielo:S0100-69912016000400243Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2016-09-16T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false
dc.title.none.fl_str_mv Mirizzi syndrome grades III and IV: surgical treatment
title Mirizzi syndrome grades III and IV: surgical treatment
spellingShingle Mirizzi syndrome grades III and IV: surgical treatment
REVERDITO,RONALD
Mirizzi Syndrome. Jaundice
Obstrutive. Epidemiology. Therapeutics. Surgical Procedures
Operative.
title_short Mirizzi syndrome grades III and IV: surgical treatment
title_full Mirizzi syndrome grades III and IV: surgical treatment
title_fullStr Mirizzi syndrome grades III and IV: surgical treatment
title_full_unstemmed Mirizzi syndrome grades III and IV: surgical treatment
title_sort Mirizzi syndrome grades III and IV: surgical treatment
author REVERDITO,RONALD
author_facet REVERDITO,RONALD
MORICZ,ANDRÉ DE
CAMPOS,TÉRCIO DE
PACHECO JÚNIOR,ADHEMAR MONTEIRO
SILVA,RODRIGO ALTENFELDER
author_role author
author2 MORICZ,ANDRÉ DE
CAMPOS,TÉRCIO DE
PACHECO JÚNIOR,ADHEMAR MONTEIRO
SILVA,RODRIGO ALTENFELDER
author2_role author
author
author
author
dc.contributor.author.fl_str_mv REVERDITO,RONALD
MORICZ,ANDRÉ DE
CAMPOS,TÉRCIO DE
PACHECO JÚNIOR,ADHEMAR MONTEIRO
SILVA,RODRIGO ALTENFELDER
dc.subject.por.fl_str_mv Mirizzi Syndrome. Jaundice
Obstrutive. Epidemiology. Therapeutics. Surgical Procedures
Operative.
topic Mirizzi Syndrome. Jaundice
Obstrutive. Epidemiology. Therapeutics. Surgical Procedures
Operative.
description ABSTRACT Objective : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. Methods : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. Results : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. Conclusion : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity.
publishDate 2016
dc.date.none.fl_str_mv 2016-08-01
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912016000400243
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/0100-69912016004005
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dc.publisher.none.fl_str_mv Colégio Brasileiro de Cirurgiões
publisher.none.fl_str_mv Colégio Brasileiro de Cirurgiões
dc.source.none.fl_str_mv Revista do Colégio Brasileiro de Cirurgiões v.43 n.4 2016
reponame:Revista do Colégio Brasileiro de Cirurgiões
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