ARTÍCULO  ORIGINALES

 

EL SÍNDROME DE COMPRESIÓN BILIAR EXTRÍNSECA

BENIGNA O SÍNDROME DE MIRIZZI: EXPERIENCIA

DE CINCO AÑOS EN EL HOSPITAL DE SAN JOSÉ

 

VOLUMEN 23 No. 1 ENERO - MARZO  2008  

 

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Nuestro trabajo aporta datos importantes sobre el síndrome de Mirizzi; muestra una frecuencia elevada de este cuadro clínico y demuestra una importante presentación del síndrome durante los años evaluados: 3,85%, en contraste con lo que aparece reportado en la literatura que informa menores tasas de incidencia. No existen estudios de elección para el diagnóstico preciso del síndrome de Mirizzi en el periodo preoperatorio, lo que supone el desarrollo de destrezas para su adecuado manejo pues suele ser un hallazgo intraoperatorio. Recomendamos, al igual que Yang-Tan et al., practicar colecistectomía y reconstrucción con hepaticoyeyunostomía y asa subcutánea en los pacientes con síndrome de Mirizzi tipos II, III y IV.

 

The benign extrinsec compression biliary syndrome (Mirizzi syndrome): five years experience at San José Hospital, Bogotá, Colombia

 


 

Syndrome of external biliary compression or Mirizzi´s Syndrome: five-year experience at Hospital San José (Bogotá)

 

Abstract

 

Introduction: The syndrome of external biliary compression, or Mirizzi´s Syndrome, described by Pablo Mirizzi in Argentina in 1948, is an infrequent surgical entity that constitutes a real diagnostic and management challenge.

 

Materials and Methods: Retrospective descriptive study of cases bases on the clinical records of 934 patients subjected to cholecystectomy at Hospital San José (Bogotá, Colombia) in the period 2001-2005. Epidemiological data, surgical procedures performed, and morbidity and mortality were analyzed at this high-complexity level of care institution.

 

Results: 36 patients had Mirizi´s syndrome. According to A. Csendes´ classification there were 31 (86%) patients with type I Mirizi´s syndrome, 1 (2.7%) type II, 3 (8.3%) type III, and 1(2.7%) type IV, for an overall prevalence of 3.85%.

 

Conclusion: World literature reports a prevalence of Mirizzi´s Syndrome of 0.7 to 1.4%, while at Hospital San Jose prevalence was 3.85%. Our Hospital is a recognized center in the managements of biliary pathology, where surgeons achieve a high level of training, which perhaps makes improbable an overestimation of the concept and diagnosis of Mirizi´s syndrome.

 

Key words: common bile duct, cholelithiasis, choledocholithiasis, cholecystectomy, cholecystectomy

laparoscopic, biliary tract surgical procedures.

 


 

Referencias

 

1. AL-AKEELY MHA, ALAM MK, BISMAR HA, KHALID K, AL-TEIMI I. Mirizzi syndrome: ten years experience from a teaching hospital in Riyadh. World J Surg 2005; 29:1687-92.

 

2. CORTÉS M, VÁSQUEZ A. Frecuencia del síndrome de Mirizzi en un hospital de enseñanza. Cirujano General 2003; 25:334-7.

 

3. SCHAFER M, SCHNEITER R, KRAHENBUHL L. Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy. Surg Endosc 2003; 17:1186-1190.

 

4. TAN KY, CHUNG HC, CHEN CY, TAN SM, POH BK, HOE MN. Mirizzi syndrome: noteworthy aspects of a retrospective study in one centre. ANZ J Surg 2004; 74:833-7.

 

5. CSENDES A, DÍAZ JC, BURDILES P, MALUENDA F, NAVA O. Mirizzi syndrome and cholecystobiliary fistula: a unifying classification. Br J Surg 1989; 76:1139-43.

 

6. REYES CEREZO M, SOLÓRZANO PECK G, REDEL DEL PUEYO J, VÁZQUEZ MÁRQUEZ L, GORDON DEL RÍO A, ARÉVALO JIMÉNEZ E, PERA MADRAZO C. Mirizzi syndrome: apropos of 13 cases. Rev Esp Enf Aparato Digestivo. 1989; 75:475-80.

 

7. SHAH OJ, DAR MA, WANI MA, WANI NA. Management of Mirizzi syndrome: a new surgical approach. ANZ J Surg 2001; 71:423-7.

 

Correspondencia:

GUILLERMO ALDANA DIMAS, MD.

Correo electrónico: galdana1@hotmail.com

Bogotá, Colombia

 

 

 

 

 

 

 

 

 

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