Guidelines For Clinical Practice
Copyright ©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Sep 14, 2012; 18(34): 4639-4650
Published online Sep 14, 2012. doi: 10.3748/wjg.v18.i34.4639
Table 4 New proposed classification and suggested surgical treatment for Mirizzi syndrome
Type of MirizziDescriptionTreatment
IExternal compression of the bile ductOpen cholecystectomy
Open subtotal cholecystectomy
Laparoscopic cholecystectomy
Laparoscopic subtotal cholecystectomy
IIaCholecystobiliary fistula < 50% the diameter of the bile ductOpen cholecystectomy
Open subtotal cholecystectomy
IIbCholecystobiliary fistula > 50% the diameter of the bile ductOpen subtotal cholecystectomy
Biliary-enteric derivation:
Side-to-side to the duodenum
En-Y-de-Roux to the Jejunum
IIIaCholecystobiliary fistula and cholecystoenteric fistula without gallstone ileusSimple closure of the fistula and treatment of the gallbladder according to the presence of Mirizzi I, IIa or IIb
IIIbCholecystobiliary fistula and cholecystoenteric fistula with gallstone ileusTreatment of the gallstone ileus and deferred treatment of the gallbladder according to the presence of Mirizzi I, IIa or IIb