Korean J Hepatobiliary Pancreat Surg.  2013 May;17(2):79-82. 10.14701/kjhbps.2013.17.2.79.

Laparoscopic treatment for post-cholecystectomy Mirizzi syndrome

  • 1Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. jangyongjeon@yahoo.com
  • 2Department of Gastroenterology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 3Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.


The remnant cystic duct or gallbladder neck calculus may rarely result in post-cholecystectomy Mirizzi syndrome. Various managements have been proposed for the treatment of post-cholecystectomy Mirizzi syndrome. Some previous cases of post-cholecystectomy Mirizzi syndrome have been managed with open cholecystectomy and endoscopically. We report a case of a laparoscopic stone removal of post-cholecystectomy Mirizzi syndrome that developed 7 months after laparoscopic cholecystectomy. To our knowledge, this is the first case of laparoscopic management of post-cholecystectomy Mirizzi syndrome. The mechanism, diagnosis and treatment of post-cholecystectomy Mirizzi syndrome are discussed.


Mirizzi syndrome; Cholecystectomy; Gallstone

MeSH Terms

Cholecystectomy, Laparoscopic
Cystic Duct
Mirizzi Syndrome


  • Fig. 1 Coronal T2-weighted image shows a cystic duct stone representing as dark signal intensity round lesion (arrows) and shows remnant cystic duct appearing tubular hyperintense lesion (arrowhead).

  • Fig. 2 An ovoid filling defect is noted in mid CBD level, which resulted in mild dilatation of above the common hepatic duct and intrahepatic bile ducts.

  • Fig. 3 An 1.2 cm-sized high density stone (arrow) is abutting the ENBD tube (arrowhead), posteriorly.

  • Fig. 4 Gallstone removal after incision of the wall of the remnant cystic duct.

  • Fig. 5 Intraoperative cholangiography showing no stenosis of the common bile duct and no bile leakage.


1. Johnson LW, Sehon JK, Lee WC, et al. Mirizzi's syndrome: experience from a multi-institutional review. Am Surg. 2001; 67:11–14. PMID: 11206888.
2. Pemberton M, Wells AD. The Mirizzi syndrome. Postgrad Med J. 1997; 73:487–490. PMID: 9307740.
3. Janes S, Berry L, Dijkstra B. Management of post cholecystectomy Mirizzi's syndrome. J Minim Access Surg. 2005; 1:34–36. PMID: 21234142.
4. Joo SH, Kim KH, Yun EJ, et al. Laparoscopic removal of a retained gallbladder with remnant cystic duct calculi. Korean J Hepatobiliary Pancreat Surg. 2006; 10:47–51.
5. McSherry CK, Ferstenberg H, Virship M. The Mirizzi syndrome: suggested classification and surgical therapy. Surg Gastroenterol. 1982; 1:219–225.
6. Csendes A, Díaz JC, Burdiles P, et al. Mirizzi syndrome and cholecystobiliary fistula: a unifying classification. Br J Surg. 1989; 76:1139–1143. PMID: 2597969.
7. Antoniou SA, Antoniou GA, Makridis C. Laparoscopic treatment of Mirizzi syndrome: a systematic review. Surg Endosc. 2010; 24:33–39. PMID: 19466486.
8. Yonetci N, Kutluana U, Yilmaz M, et al. The incidence of Mirizzi syndrome in patients undergoing endoscopic retrograde cholangiopancreatography. Hepatobiliary Pancreat Dis Int. 2008; 7:520–524. PMID: 18842500.
9. Wani NA, Khan NA, Shah AI, et al. Post-cholecystectomy Mirizzi's syndrome: magnetic resonance cholangiopancreatography demonstration. Saudi J Gastroenterol. 2010; 16:295–298. PMID: 20871198.
10. Mithani R, Schwesinger WH, Bingener J, et al. The Mirizzi syndrome: multidisciplinary management promotes optimal outcomes. J Gastrointest Surg. 2008; 12:1022–1028. PMID: 17874273.
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