Case Report

Combined Endoscopic and Laparoscopic Management of Postcholecystectomy Mirizzi Syndrome from a Remnant Cystic Duct Stone: Case Report and Review of the Literature

Table 3

Review of literature describing surgical management of postcholecystectomy syndrome from remnant cystic duct calculi.

ā€‰Number of patients with postcholecystectomy Mirizzi syndromeMean time of presentation from initial operationType of initial operation and indicationIndication for initial operationSurgical management of postcholecystectomy Mirizzi syndromeOutcome at follow-up

Palanivelu et al. [9]15
(all 15 patients underwent surgical management)
8 monthsLaparoscopic subtotal cholecystectomy in 13 patients
Conventional laparoscopic cholecystectomy in 2 patients
Acute cholecystitis in 13 patients
Indication not mentioned in 2 patients undergoing conventional cholecystectomy
Laparoscopic retrieval of remnant cystic duct stone in all patients
(i) Primary closure of common bile duct in 11 patients
(ii) Closure of common bile duct around T-tube in 4 patients
CBD stone in 1 patient post-op managed with ERCP and stent
Biliary pancreatitis in 1 patient
All patients were symptom-free at 3-month follow-up

Phillips et al. [3] 12
(6 out of 12 patients underwent surgical management)
34.2 monthsLaparoscopic cholecystectomy in 9 patients
Open cholecystectomy in 3 patients
Acute cholecystitis in 5 patients
Chronic cholecystitis in 7 patients
(i) Open retrieval of cystic duct remnant calculi and open common bile duct exploration in 6 patients
(ii) 1 patient refused surgical intervention after failed ERCP
Follow-up available in 9 patients
Resolution of symptoms in 7 patients out of these 9 patients at mean follow-up of 11.8 months

Walsh et al. [4] 7
(5 out of 7 patients underwent surgical management)
8.5 yearsLaparoscopic cholecystectomy in 4 patients
Open cholecystectomy in 3 patients
Acute cholecystitis in 2 patients
Chronic cholecystitis in 5 patients
(i) Open retrieval of cystic duct remnant stone in 4 patients
(ii) Laparoscopic retrieval of cystic duct remnant stone in 1 patient
All patients were symptom-free at mean follow-up of 31 months

Tantia et al. [10] 7
(7 out of 7 patients underwent surgical management)
12.8 yearsOpen cholecystectomy in 6 patients
Laparoscopic cholecystectomy in 1 patient
Not knownLaparoscopic completion cholecystectomy in 7 patients with laparoscopic common bile duct exploration in 2 patients (primary CBD closure in 1 patient and choledochoduodenostomy in 1 patient)All patients were symptom-free at 3-month follow-up

Chowbey et al. [11] 3
(3 out of 3 patients underwent surgical management)
7.6 monthsLaparoscopic subtotal cholecystectomy in 3 patientsNot knownLaparoscopic completion cholecystectomy in 3 patientsAll patients were symptom-free at mean follow-up of 2.3 years

Endo et al. [12] 18 yearsOpen cholecystectomyNot knownOpen retrieval of cystic duct remnant stone and closure of CBD defect with T-tube placementSymptom-free with resolution of common bile duct stricture at 9-month follow-up

Gurel et al. [13] 132 yearsOpen cholecystectomyAcute cholecystitisLaparoscopic completion cholecystectomy and retrieval of gallbladder remnant stone Symptom-free at discharge with resolution of LFTs at discharge

Pernice and Andreoli [14] 116 yearsLaparoscopic cholecystectomyChronic cholecystitisLaparoscopic completion cholecystectomy of gallbladder remnantSymptom-free at 8-month follow-up

Sahoo and Kumar [15] 16 yearsLaparoscopic cholecystectomyNot knownLaparoscopic retrieval of cystic duct stump stone and intracorporeal closure of stumpSymptom-free at discharge