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Late postcholecystectomy Mirizzi syndrome due to a sessile gall bladder remnant calculus managed by laparoscopic completion cholecystectomy: a feasible surgical option
  1. Gunjan S Desai,
  2. Prasad Pande,
  3. Rajvilas Narkhede and
  4. Prasad Wagle
  1. Department of Gastrointestinal Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
  1. Correspondence to Dr Gunjan S Desai, desaigunjan526{at}, dsshlsh{at}


Postcholecystectomy Mirizzi syndrome (PCMS) is an uncommon entity that can occur due to cystic duct stump calculus, gall bladder remnant calculus or migrated surgical clip. It can be classified into early PCMS or late PCMS. It is often misdiagnosed and the management depends on the site of impaction of stone or clip. Endoscopy can be performed for cystic duct stump calculus. However, surgery is the treatment for remnant gall bladder calculus. Role of laparoscopic management is controversial. We present here a case of a 48-year-old woman with late PCMS due to an impacted calculus in a sessile gall bladder remnant following a subtotal cholecystectomy, managed with laparoscopic completion cholecystectomy, review the literature, provide tips for safe laparoscopy for PCMS and summarise our algorithmic approach to the management of the postcholecystectomy syndrome.

  • endoscopy
  • gastrointestinal surgery
  • general surgery
  • biliary intervention
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  • Contributors GSD, RN and PP: worked for the literature review and the manuscript preparation under the creative inputs, critical evaluation and guidance of PW. All authors have worked on the article generation and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Not declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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