| Theme | Treatment of Choledocholithiasis | |
|---|---|---|
| Title | Mirizzi Syndrome and Impacted Stone | |
| Publish Date | 2017/01 | |
| Author | Toshio Tsuyuguchi | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| Author | Harutoshi Sugiyama | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| Author | Junichiro Kumagai | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| Author | Koji Takahashi | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| Author | Rintaro Mikata | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| Author | Yuji Sakai | Department of Gastroenterology, and Nephrology, Chiba University Graduate School of Medicine |
| [ Summary ] | We reviewed endoscopic management for Mirizzi syndrome (MS) and impacted bile duct stones. MS was classified into the following two types : type I in which the acute form is characterized by external compression of the adjacent common hepatic duct, and type II in which a pressure necrosis of the common bile duct results in a cholecystocholedochal fistula. MS type I is amenable to surgical cholecystectomy. Peroral cholangioscopy‒direct lithotripsy by using electrohydraulic or laser lithotripsy is useful for MS type II because impacted stones at the fistula can be approached by a peroral cholangioscope. Similarly, impacted bile duct stones are a good candidate for direct lithotripsy under cholangioscopic guidance. There was no procedure‒related complication without transient cholangitis which is resolved by conservative treatment. | |