Laparoscopic treatment of Mirizzi syndrome

Mirizzi syndrome is a rare disorder and remains a surgical challenge. It is generally considered as a contraindication to laparoscopic surgery. Three patients with Mirizzi type II syndrome and two patients with Mirizzi type I syndrome were treated laparoscopically. Partial cholecystectomy with fundu s-first dissection of the gallbladder was performed, and closure of the fis tula in type II syndrome was achieved over a T-tube. The common bile duct ( CBD) was explored in one patient using a choledochoscope through the fistul a. The procedure was completed laparoscopically in all five patients. The t hree patients with type II syndrome had residual CBD stones, which were ass ociated with significant morbidity and mortality. Laparoscopic treatment of Mirizzi type I syndrome is technically feasible and safe. For Mirizzi type II syndrome, laparoscopic CBD exploration is demanding and experience, ski ll, and the full spectrum of modern technology are required.