Ann Surg Treat Res.  2018 Feb;94(2):106-111. 10.4174/astr.2018.94.2.106.

Single incision laparoscopic cholecystectomy for patients with Mirizzi syndrome

• Chang WB
• Han HS
• Yoon YS
• Cho JY
• Choi Y

• KMID: 2402854
• DOI: http://doi.org/10.4174/astr.2018.94.2.106

Abstract

Since multiport laparoscopic cholecystectomy has become a standard treatment for gallbladder (GB) disease, a single incision laparoscopic surgical technique has been tried to decrease the surgical site pain and achieve a better cosmetic out come in selected patients. The development of devices dedicated for single incision laparoscopic cholecystectomy (SILC) is expanding the indication of this single incision laparoscopic technique to more complicated GB diseases. Mirizzi syndrome (MS) is one of the complex uncommon gallstone diseases in patients undergoing cholecystectomy. Because the laparoscopic procedure has become a routine treatment for cholecystectomy, several studies have reported their experience with the laparoscopic technique for the treatment of MS with a comparable outcome in Csendes type I or II. Because the indication for SILC cholecystectomy is expanded to more complicated GB conditions, and the desire of patients for a less painful, better cosmetic surgical outcome has increased, our medical center used this single incision laparoscopic surgical technique for MS Csendes types I and II patients. Here, we report 2 successful cases of SILC for patients with MS types I and II without significant morbidity.

Keyword

Laparoscopic cholecystectomy; Cholecystitis; Single incision; Mirizzi syndrome

MeSH Terms

Cholecystectomy
Cholecystectomy, Laparoscopic*
Cholecystitis
Gallbladder
Gallstones
Humans
Mirizzi Syndrome*

Figure

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  Fig. 1 Preoperative image of patient. Endoscopic retrograde cholangiopancreatography (A) and magnetic resonance cholangiopancreatography (B) show a large stone which is impacted in the distal cystic duct at the confluence of common hepatic duct.

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  Fig. 2 Intraoperative view. Opening at the proximal site of impacted stone (A), closure of opened cystic duct after stone removal and cholecystectomy (B).

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  Fig. 3 Preoperative image of patient. CT scan shows a stone in the cystic duct which is compressing common hepatic duct externally.

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  Fig. 4 Single incision laparoscopic preparation. Three centimeter of transumbilical incision was done and a glove port was placed. A scope holder was used to hold a scope for a better surgical view.

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  Fig. 5 Intraoperative view. Opening of infundibulum and gall stone extraction through this opening (A), cystic duct and artery ligation (B). GB, gallbladder.

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