Mirizzi Syndrome Type IV Successfully Treated with Peroral Single-operator Cholangioscopy-guided Electrohydraulic Lithotripsy: A Case Report with Literature Review

A 76-year-old man presented with liver dysfunction and intrahepatic bile duct dilatation. Imaging studies showed two large stones that had become impacted in the common hepatic duct, which was fused with the gallbladder. The patient was diagnosed with Mirizzi syndrome type IV. Hepaticojejunostomy an...

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Bibliographic Details
Published in:Internal Medicine 2022/12/01, Vol.61(23), pp.3513-3519
Main Authors: Kawai, Hirokazu, Sato, Toshifumi, Natsui, Masaaki, Watanabe, Kotaro, Inoue, Ryosuke, Kimura, Mayuki, Yoko, Kazumi, Sasaki, Syun-ya, Watanabe, Masashi, Ohashi, Taku, Tsukahara, Akihiro, Tanaka, Norio, Tsukada, Yoshihisa
Format: Article
Language:English
Subjects:
Aged
Bile ducts
Case Report
Catheterization
cholangioscopy
Cholangitis
cholecystobiliary fistula
electrohydraulic lithotripsy
endoscopic nasobiliary drainage
Gallbladder
Gallstones - therapy
Hepatic artery
Humans
Internal medicine
Literature reviews
Lithotripsy
Lithotripsy - methods
Liver diseases
Male
Mirizzi syndrome
Mirizzi Syndrome - surgery
Patients
SpyGlass
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Summary:A 76-year-old man presented with liver dysfunction and intrahepatic bile duct dilatation. Imaging studies showed two large stones that had become impacted in the common hepatic duct, which was fused with the gallbladder. The patient was diagnosed with Mirizzi syndrome type IV. Hepaticojejunostomy and stone removal failed due to dense gallbladder adhesions involving the right hepatic artery. The bile flow was temporarily restored; however, the patient experienced cholangitis 16 months later. The stones were extracted via peroral single-operator cholangioscopy (SOC)-guided electrohydraulic lithotripsy. This is the first case in which stones were completely removed by SOC-guided treatment in a patient with Mirizzi syndrome type IV.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9526-22