[Mirizzi syndrome associated with complicated cholelitiasis in the elderly patient. Diagnosis and laparoscopic treatment].
| Autor: | Sánchez Beorlegui J; Servicio de Cirugía General y Digestiva, Fundación Hospital de Calahorra, La Rioja, Spain. js_beorlegui@hotmail.com, Monsalve Laguna E, Soriano Gil-Albarellos P, Cabezali Sánchez R, Moreno de Marcos N, Aspíroz Sancho A |
|---|---|
| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru [Rev Gastroenterol Peru] 2008 Jan-Mar; Vol. 28 (1), pp. 15-21. |
| Abstrakt: | Introduction: The Mirizzi Syndrome (MS) is a rare variation of cholelitiasis, in which a calculus impacted in the Hartmann Pouch compresses the biliary pathway triggering an obstructive jaundice, frequently followed by inflammatory phenomenon and a number of complications. Objective: To establish the frequency of the Mirizzi Syndrome in complicated cholelitiasis in the elderly patient and analyze the most suitable diagnosis and treatment options. Patients and Method: Cases of Mirizzi Syndromes in symptomatic inflammatory biliary lithiasis were selected in a five-year period among patients older than 70, who had undergone urgent operation. Epidemiology, private hospital, diagnosis, operating variables, morbility and hospitalization were analyzed. Results: Twelve (12) patients with Mirizzi Syndrome were detected, with an average age of 77.2 in 197 cases of complicated cholelitiasis. A laparoscopic examination was made in 67% of the cases, with a conversion rate of 50%. The most frequent finding was the biliary extrinsic compression without Csendes-I fistula (58%). The postsurgical morbility was of 58%, including two deaths (17%) and the medium-term postoperative hospital stay was of 9.5 days. Conclusions: This research emphasizes the importance of the Mirizzi Syndrome (MS) in the symptomatic cholelitiasis in geriatric patients. This syndrome usually acts like a biliar surgical emergency and the early diagnosis of an elderly patient with jaundice is the key that enables immediate biliary decompression through a cholecystectomy. Management choices are in debate; however, due to its advantages in cases of elderly patients, a laparoscopic treatment is proposed, unless strictly contraindicated. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|