| Theme |
Treatment of Choledocholithiasis |
| Title |
Mirizzi Syndrome and Impacted Stone |
| 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. |