Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 5115-5121
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5115
Type I Mirizzi syndrome treated by electrohydraulic lithotripsy under the direct view of SpyGlass: A case report
Sheng-Nan Liang, Guo-Fa Jia, Li-Ying Wu, Jin-Zhi Wang, Zhen Fang, Shu-Hai Wang
Sheng-Nan Liang, Guo-Fa Jia, Li-Ying Wu, Jin-Zhi Wang, Zhen Fang, Shu-Hai Wang, Department of Gastroenterology, Huaibei People's Hospital Affiliated to Bengbu Medical College, Huaibei 235000, Anhui Province, China
Author contributions: Wu LY completed the study design; Liang SN, Jia GF, Wang JZ, Fang Z, and Wang SH completed the data analysis; Liang SN and Jia GF completed the manuscript editing; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ying Wu, Chief Physician, Department of Gastroenterology, Huaibei People's Hospital Affiliated to Bengbu Medical College, No. 32 Huaihai West Road, Xiangshan District, Huaibei 235000, Anhui Province, China. 151610926@qq.com
Received: February 22, 2023
Peer-review started: February 22, 2023
First decision: April 26, 2023
Revised: May 28, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: July 26, 2023
Processing time: 154 Days and 13.2 Hours
Abstract
BACKGROUND

Mirizzi syndrome is an uncommon clinical complication for which the available treatment options mainly include open surgery, laparoscopic surgery, endoscopic retrograde cholangiopancreatography (ERCP), electrohydraulic lithotripsy, and laser lithotripsy. Here, a patient diagnosed with type I Mirizzi syndrome was treated with electrohydraulic lithotripsy under SpyGlass direct visualization, which may provide a reference to explore new treatments for Mirizzi syndrome.

CASE SUMMARY

This paper describes a middle-aged female patient with suspected choledocholithiasis who complained for over 1 mo of intermittent abdominal pain, dark yellow urine, jaundice, and was proposed to undergo ERCP lithotomy. Mirizzi syndrome was found during the operation and confirmed by SpyGlass. Electrohydraulic lithotripsy was performed under the direct vision of SpyGlass. After the lithotripsy, the stones were extracted using the stone extraction basket and balloon. After the operation, the patient developed transient hyperamylasemia. Through a series of symptomatic treatments (such as fasting, fluids and anti-inflammation medications), the symptoms of the patient improved. Finally, laparoscopic cholecystectomy or open cholecystectomy was performed after a half-year post-operatively.

CONCLUSION

Direct visualization-guided laser or electrohydraulic lithotripsy with SpyGlass is feasible and minimally invasive for type I Mirizzi syndrome without apparent unsafe outcomes.

Keywords: Peroral cholangioscopy; Mirizzi syndrome; Lithotripsy; Endoscopic retrograde cholangiopancreatography; Obstructive jaundice; Case report

Core Tip: Mirizzi syndrome was traditionally treated with standardized open surgery and laparoscopic surgery. Recently, some less invasive alternative technologies (such as endoscopic retrograde cholangiopancreatography stone extraction and medical electrohydraulic or laser lithotripsy) are gaining attention. This study reported a clinical case of SpyGlass-confirmed Mirizzi syndrome that was successfully treated by electrohydraulic lithotripsy under direct vision.