On the Mirizzi syndrome--benign stenosis of the hepatic duct induced by a stone in the cystic duct or the neck of the gallbladder

Abstract

Three cases of Mirizzi Syndrome are reported. One of them was induced by the stone in gallbladder remnant. On the cholangiogram, one case showed narrowing of common hepatic duct near the porta hepatis, and one case revealed a tapered narrowing-like stenosis. Those findings resembled malignancy but closer examination could differentiate this syndrome from malignancy. Selective angiography was useful to differentiate the syndrome from malignancy. Even in the cases where stricture is severe, exstirpation of gallbladder or cystic duct, freeing the anterior wall of extrahepatic bile duct from marked hyperplasia of fibrous tissues and insertion of a T-tube as an internal splint through the stenosis were effective. It is the opinion of the authors, therefore, that the reconstruction of a strictured bile duct may not necessarily be done by resection of stricture and a hepatojejunostomy.