Laparoscopic treatment of Mirizzi syndrome: a systematic review

Background This article reviews the feasibility of the laparoscopic treatment of Mirizzi syndrome and determines the associated risks and complications of this technique. Methods An electronic search of the literature between 1989 and 2008 was undertaken to identify relevant articles. Studies comprising at least four patients treated by laparoscopy and reporting on the preoperative diagnosis rate and analytical conversion and complication data were considered for inclusion. Results From 66 abstracts reviewed, 10 eligible studies were identified. Conversion, complication, and reoperation rates were 41%, 20%, and 6%, respectively. The risks for open conversion and procedure-related complications were similar for patients with type I and type II Mirizzi syndrome. However, patients of studies reporting a high preoperative diagnosis rate had a significantly lower risk for conversion (p\0.05), procedure-related complications (p\0.05), and reoperation (p\0.05), when compared with studies with a low preoperative diagnosis rate. Conclusion Current evidence suggests that laparoscopic treatment of Mirizzi syndrome cannot be recommended as a standard procedure. Preoperative diagnosis of the syndrome seems an important predicting factor of technical success.