A NEW CLASSIFICATION OF MIRIZZI SYNDROME FROM DIAGNOSTIC AND THERAPEUTIC VIEWPOINTS

Background/Aims: A new classification of Mirizzi syndrome was develope d based on our experience with 30 cases. Material and Methods: Using d iagnostic and therapeutic criteria, four distinct entities were identi fied. 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 sto ne of the confluence, and Type IV by hepatic duct stenosis as a compli cation of cholecystitis in the absence of calculi impacted in the cyst ic duct or the neck of the gallbladder. Results: Of the 30 patients th ere were 14 Type I, 2 Type II, 6 Type III, and 8 Type IV patients. Dis tinctive cholangiographic features were identified. Conclusion: The th erapeutic approach differs from each of the four distinct pathologic e ntities.