MINIMALLY INVASIVE APPROACH IN MIRIZZIS SYNDROME

During a 4-year period (November 1990-September 1994), 1152 patients u nderwent laparoscopic cholecystectomy (LC). In five (0.4%) patients a cholecysto-choledochal fistula (Mirizzi's syndrome type II) was diagno sed and a minimally invasive treatment (endoscopy-laparoscopy-interven tional radiology) was attempted.The first two cases were converted to open surgery probably because of severe anatomical distortion and inad equate confidence in performing a laparoscopic choledochal repair. The last three patients were successfully treated by minimally invasive p rocedures. These data indicate that a minimally invasive treatment can be safely attempted through a multidisciplinary approach in Mirizzi's syndrome.