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
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.
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.
GUILLERMO ALDANA DIMAS, MD.
Correo electrónico: [email protected]