An elderly gentleman with medico family came with a very complex problem and previous failed laparoscopic surgical attempt at another hospital.
The patient had gallbladder stone causing fistula with stomach duodenum 1st part as well as bile duct. As a result he had air in biliary tree and gallbladder with severe infection and bile infection giving rise to acute cholecystectitis and cholangitis.
Speaking to News Sense, Dr Suddhasattwa Sen, who led the operation said, “Patient had other risk factors too. We operated by open surgery and took a very small contracted only 2 cm small gallbladder after very painstaking dissection. The holes in stomach duodenum junction were repaired by Graham patch method and Mirizzi was dealt with as per standard protocol after biliary clearance and flushing.”
The operation was swift, without blood loss and hence no transfusion required, the patient didn’t required ICU support, OT time was much less than expected and was conducted within one hour without any further complications. The patient was discharged without any glitch after 6 days.
Mirizzi Type 5 syndrome as it is also called is one of the rarest in the world. Total Mirizzi type 1 to 4 represent only 2.8 % of total gallbladder cases. This is even rarest amongst all Mirizzi Syndrome.
