Mirizzi's syndrome.

Mirizzi's syndrome is a partial obstruction of the biliary tree caused by a stone impacted in the cystic duct, with or without development of a cholecysto-biliary fistula. We report our experience with five cases and review current methods of diagnosis and management. Preoperative diagnosis greatly facilitates management. Diagnosis may require a combination of ultrasonography, computed tomography, and cholangiography (percutaneous or endoscopic retrograde). At surgery, dissection in the triangle of Calot should be minimized to avoid injury to the common bile duct. Often, a partial cholecystectomy is the only safe option. Defects in the common bile duct can be repaired by a variety of methods. The morbidity and mortality associated with this rare syndrome can be relatively high. A number of patients may have late biliary strictures.