Treatment of Mirizzi Syndrome Type II — Cholecystobiliary Fistula Involving Less Than One-Third of the Common Bile Duct

Clinical Scenario

Mirizzi syndrome type II is characterised by a cholecystobiliary fistula that erodes into, and involves, less than one-third of the circumference of the common bile duct. This subtype accounts for approximately 41% of Mirizzi syndrome cases and represents a more anatomically complex presentation than simple extrinsic compression, requiring specific operative planning to address the bile duct involvement.

Surgical Approach — Partial Overview

Management centres on surgical intervention addressing both the gallbladder and the compromised segment of the common bile duct. The operative strategy involves exploration of the bile duct and measures to protect the repaired duct wall.

The full protocol — including technique selection, precise access route, and intraoperative drainage strategy — is detailed in the complete structured regimen below.