Search

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mirizzi syndrome (MS) is a syndrome that causes chronic destructive and fibrotic changes because of compression and inflammation in the main biliary tract. MS remains to be a serious problem due to its high morbidity. In this study, it is aimed to evaluate the diagnostic tools, risk factors and clinical output data we apply to our patients with MS in the light of the literature. We retrospectively analyzed the data of patients treated for MS in the last decade in our hospital, where an average of 1350 cholecystectomies are performed annually. Clinical, laboratory and imaging data obtained from patients' files were evaluated. We identified 76 patients with MS and classified them as type 1-5 according to the Csendes classification. Abdominal pain, fever and jaundice were the most common symptoms. 42 patients had type 1 and 2 MS. Mirizzi syndrome was diagnosed with preoperative radiological imaging methods in 24 of the patients. In 41 of the patients, the surgery first started laparoscopically, and then turned to laparotomy in 39 patients. Other 35 patients were operated with conventional methods. In 11 cases, subtotal cholecystectomy was performed Early diagnosis and surgical treatment of symptomatic cholelithiasis decrease the frequency of MS. Inflammation criteria can be used as an indicative biomarker. The patient's history, USG, ERCP and MRCP findings are currently the most important diagnostic tools. Releasing the gallbladder with the "fundus first" approach can reduce the risk of trauma. In cases where MS is suspected, a stent placed with ERCP decrease bile duct trauma. KEY WORDS: Complication, Diagnosis, Mirizzi's syndrome, Prediction, Treatment.

Background: One of the most feared complications of surgeons dealing with hepato-pancreato-biliary (HPB) surgery is hepatic artery (HA) injury. Here, we aimed to evaluate our clinical experience (laceration, transection, ligation, and resection) related to HA traumas, which have serious morbidity and mortality risks, in the light of literature data and the rapidly evolving management methods in recent years., Methods: The files of 615 patients who were operated on for HPB pathologies in the last decade, in our hospital, were retrospectively reviewed. Clinical, laboratory, and imaging data obtained from patients' files were evaluated., Results: A total of 13 HA traumas were detected, eight of them had HA injury and five had planned HA resection. During the post-operative follow-up period, liver abscess, anastomotic leakage, and late biliary stricture were detected., Conclusion: Complications and deaths due to HA injury or ligation are less common today. The risk of complications increases in patients with hemodynamically unstable, jaundice, cholangitis, and sepsis. Revealing the variations in the pre-operative radiological evaluation and determining the appropriate approach plan will reduce the risks. In cases where HA injury is detected, arterial flow continuity should be tried to be maintained with primary anastomosis, arterial transpositions, or grafts.