A new classification of Mirizzi syndrome from diagnostic and therapeutic viewpoints.

BACKGROUND/AIMS: A new classification of Mirizzi syndrome was developed based on our experience with 30 cases.

MATERIAL AND

METHODS

Using diagnostic and therapeutic criteria, four distinct entities were identified. Type I characterized by stenosis of the common hepatic duct due to a stone impacted in the cystic duct or the neck of the gallbladder. Type II is characterized by fistulization of the common hepatic duct as a result of a stone embedded in the cystic duct or the neck of the gallbladder. Type III is defined by hepatic duct stenosis due to a stone of the confluence, and Type IV by hepatic duct stenosis as a complication of cholecystitis in the absence of calculi impacted in the cystic duct or the neck of the gallbladder.

RESULTS

Of the 30 patients there were 14 Type I, 2 Type II, 6 Type III, and 8 Type IV patients. Distinctive cholangiographic features were identified.

CONCLUSION

The therapeutic approach differs from each of the four distinct pathologic entities.