Síndrome de Mirizzi: Causa Comum de Conversão da Colecistectomia Laparoscópica Mirizzis Syndrome: Common Cause of Laparoscopic Cholecystectomy Conversion

RESUMO This case refers to a case of a patient with obstructive jaundice, with diagnostic suspicion in the pre operative period of Mirizzi s Syndrome (MS). The initial surgical approach was carried on by laparoscopic via that confirmed the diagnosis of Mirizzi s Syndrome, classified as type III of Csendes. The surgical conversion was done due to the technical difficulty. There are doubts and concerns if laparoscopic is the best surgical approach to the treatment of this syndrome.1 Some authors do not consider the laparoscopy as the first choice due to the jaundice and acute inflammation, witch are considered by some a non indication to the minimally invasive treatment.2,3 We believe that the laparoscopic procedure is safe and, in some cases, allows the complete treatment. The best choice is to attempt the dissection of the biliary duct, by laparoscopic via, and to convert to an open surgery if the local conditions are not totally clear. Anatomic alterations, poor visualization of the main duct distal extremity, impossibility of taking out the calculi or the impossibility to make a safe repair of the choledocho are some of these causes of surgical conversion.