{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:48:58Z","timestamp":1792194538530,"version":"4.4.0"},"reference-count":102,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Background:<\/jats:bold>\n Mirizzi syndrome (MS) is a rare condition in which the common bile duct or hepatic duct is blocked by impacted gallstones. It can cause symptoms such as cholecystitis, including abdominal pain, nausea, and vomiting. Although diagnosis is challenging, imaging techniques such as ultrasonography and CT scans are helpful. The gold standard for diagnosis is ERCP (Endoscopic Retrograde Cholangiopancreatography). Surgical management is the primary treatment, with laparotomy preferred over laparoscopic procedures.\n <\/jats:p>\n \n Methodology:<\/jats:bold>\n This prospective study was conducted over a period of five years at a tertiary care hospital in Pakistan. A total of 72 patients, aged 21\u201370 years (mean age 44.81 years), with symptomatic cholelithiasis were included. All patients underwent ultrasonography and, in selected cases, MRCP (Magnetic Resonance Cholangiopancreatography) and ERCP were performed preoperatively. MS was detected preoperatively in 19.4% of cases and intraoperatively in the remaining cases. Data were analyzed using SPSS version 28.\n <\/jats:p>\n \n Results:<\/jats:bold>\n Of the 72 patients, 75% were female. Most patients (69.4%) presented with the right hypochondrium pain, while 16.7% presented with pain and jaundice. Preoperative liver function tests were abnormal in 44.4% of patients. Imaging techniques used included ultrasound (100% of patients), MRCP (22.2%), and ERCP (8.3%). Laparoscopic cholecystectomy was completed in 63.8% of patients, with a conversion rate to open surgery of 30.55%. Two patients required open cholecystectomy with hepaticojejunostomy due to gallstone ileus. The MS types identified were type I (50%), type II (25%), type III (19.4%), type IV (2.77%), and type V (2.77%).\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n MS is a rare and challenging condition to diagnose. Although imaging techniques are helpful, ERCP remains the gold standard. Surgical management, particularly laparoscopic cholecystectomy, is effective but requires careful implementation by experienced surgeons to avoid complications. In complex cases, laparotomy remains a necessary option.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.8","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T03:30:26Z","timestamp":1745206226000},"source":"Crossref","is-referenced-by-count":4,"title":["Mirizzi Syndrome: Clinical Insights, Diagnostic Challenges, and Surgical Outcomes \u2013 A 5-Year Experience from a Tertiary Care Hospital in Pakistan"],"prefix":"10.5339","volume":"2025","author":[{"given":"Hira","family":"Moosa","sequence":"first","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabina","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Naeem","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleena","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rameez","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansharah","family":"Mirza","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Abdul Wasay Zuberi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anum","family":"Iftikhar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8032-7462","authenticated-orcid":true,"given":"Hussain Haider","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Patoli","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinnah Postgraduate Medical Center Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afnan W.M.","family":"Jobran","sequence":"additional","affiliation":[{"name":"Department of Medicine, Alquds University, Jerusalem, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Hafiz Yusuf","sequence":"additional","affiliation":[{"name":"Department of Oto Rhino Laryngology, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4776-9064","authenticated-orcid":true,"given":"Sameer","family":"Abdul Rauf","sequence":"additional","affiliation":[{"name":"Department of Medicine, Liaquat National Medical College, Karachi, Pakistan*Correspondence: Sameer Abdul Rauf. Email: sameerrauf80@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"14:","key":"CIT0001","series-title":"BMC Surg","first-page":"90","article-title":"Acute acalculous cholecystitis determining Mirizzi syndrome: case report and literature review","author":"Milone\n \nM\n,","year":"2014"},{"issue":"27:","key":"CIT0002","series-title":"Pan Afr Med J","first-page":"45","article-title":"Le syndrome de Mirizzi: une cause rare de l'obstruction des voies biliaires: \u00e0 propos d'un cas et revue de litt\u00e9rature","author":"Bellamlih\n \nH\n,","year":"2017"},{"issue":"(4):","key":"CIT0003","series-title":"Acta Gastroenterol Latinoam","first-page":"323\u2013328","article-title":"S\u00edndrome de Mirizzi: Prevalencia, diagn\u00f3sticoy tratamiento [Mirizzi Syndrome: Prevalence, diagnosis and treatment]","volume":"44","author":"Acquafresca\n \nP\n,","year":"2014;"},{"key":"CIT0004","author":"Jones\n \nMW\n,"},{"issue":"1:","key":"CIT0005","series-title":"Surg Gastroenterol","first-page":"219\u2013225","article-title":"The Mirizzi Syndrome: Suggested Classification and Surgical Therapy","author":"McSherry,\n \nC.K.\n,","year":"1982;"},{"issue":"(34):","key":"CIT0006","series-title":"World J Gastroenterol","first-page":"4639\u20134650","article-title":"Mirizzi syndrome: history, current knowledge and proposal of a simplified classification","volume":"18","author":"Beltr\u00e1n\n \nMA","year":"2012"},{"issue":"(11):","key":"CIT0007","series-title":"Br J Surg","first-page":"1139\u20131143","article-title":"Mirizzi syndrome and cholecystobiliary fistula: a unifying classification","volume":"76","author":"Csendes\n \nA\n,","year":"1989"},{"issue":"(10):","key":"CIT0008","series-title":"World J Surg","first-page":"2237-2243","article-title":"The relationship of Mirizzi syndrome and cholecystoenteric fistula: validation of a modified classification","volume":"32","author":"Beltran\n \nMA\n,","year":"2008"},{"issue":"(9):","key":"CIT0009","series-title":"Diagnostics (Basel)","first-page":"1660","article-title":"The Current approach to the diagnosis and classification of Mirizzi syndrome","volume":"11","author":"Klekowski\n \nJ\n,","year":"2021"},{"issue":"(10):","key":"CIT0010","series-title":"ANZ J Surg","first-page":"708\u2013713","article-title":"Appraisal of diagnosis and surgical approach for Mirizzi syndrome","volume":"82","author":"Cui\n \nY\n,","year":"2012"},{"issue":"(3):","key":"CIT0011","series-title":"Gastrointest Radiol","first-page":"265\u2013228","article-title":"Mirizzi syndrome and biliobiliary fistulas: roentgenologic appearance","volume":"6","author":"Cornud\n \nF\n,","year":"1981;"},{"issue":"(2):","key":"CIT0012","series-title":"Am J Gastroenterol","first-page":"249\u2013254","article-title":"Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus","volume":"97","author":"Abou-Saif\n \nA\n,","year":"2002"},{"issue":"(4):","key":"CIT0013","series-title":"Medicine (Baltimore)","first-page":"e9691","article-title":"Current trends in the management of Mirizzi syndrome: a review of literature","volume":"97","author":"Chen\n \nH\n,","year":"2018"},{"issue":"(3):","key":"CIT0014","series-title":"Surg Laparosc Endosc Percutan Tech","first-page":"248\u2013252","article-title":"A minimally invasive strategy for Mirizzi syndrome type II: Combined endoscopic with laparoscopic approach","volume":"26","author":"Yuan\n \nH\n,","year":"2016"},{"issue":"(5):","key":"CIT0015","series-title":"Pak J Med Sci","first-page":"1275\u20131279","article-title":"Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction \u2013 finding a better diagnostic tool","volume":"39","author":"Khan\n \nRSA\n,","year":"2023"},{"issue":"5:","key":"CIT0016","series-title":"Int Semin Surg Oncol","first-page":"12","article-title":"Mirizzi syndrome: an unexpected problem of cholelithiasis. Our experience with 27 cases","author":"Safioleas\n \nM\n,","year":"2008"},{"issue":"(3):","key":"CIT0017","series-title":"Laparosc Endosc Robot Surg","first-page":"85\u201391","article-title":"Robotic-assisted cholecystectomy: current status and future application","volume":"5","author":"Chandhok\n \nS\n,","year":"2022"},{"issue":"(1):","key":"CIT0018","series-title":"J Am Coll Surg","first-page":"114\u2013119; discussion 120-1","article-title":"Diagnosis and treatment of Mirizzi syndrome: 23-year Mayo Clinic experience","volume":"213","author":"Erben\n \nY\n,","year":"2011"},{"issue":"(3):","key":"CIT0019","series-title":"Ann Hepatobiliary Pancreat Surg","first-page":"122\u2013130","article-title":"Mirizzi syndrome: necessity for safe approach in dealing with diagnostic and treatment challenges","volume":"21","author":"Shirah\n \nBH\n,","year":"2017"},{"issue":"(4):","key":"CIT0020","series-title":"Semin Intervent Radiol","first-page":"332\u2013336","article-title":"Biliary interventions: delayed diagnosis of Mirizzi syndrome","volume":"33","author":"Oladini\n \nO\n,","year":"2016"},{"issue":"(1):","key":"CIT0021","series-title":"Ann Surg","first-page":"59\u201363","article-title":"The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients","volume":"202","author":"Mcsherry\n \nCK\n,","year":"1985"},{"issue":"(1):","key":"CIT0022","series-title":"Medicina (Kaunas)","first-page":"12","article-title":"Mirizzi syndrome\u2014the past, present, and future","volume":"60","author":"Koo\n \nJGA\n,","year":"2023"},{"issue":"(2):","key":"CIT0023","series-title":"Gastroenterology","first-page":"508\u2013516","article-title":"Gallstone disease is associated with increased mortality in the United States","volume":"140","author":"Ruhl\n \nCE\n,","year":"2011"},{"issue":"(2):","key":"CIT0024","series-title":"Gut Liver","first-page":"172\u2013187","article-title":"Epidemiology of gallbladder disease: cholelithiasis and cancer","volume":"6","author":"Stinton\n \nLM\n,","year":"2012"},{"issue":"(3):","key":"CIT0025","series-title":"Int J Obes Relat Metab Disord","first-page":"153\u2013158","article-title":"Gallstones in patients with morbid obesity. Relationship to body weight, weight loss and gallbladder bile cholesterol solubility","volume":"17","author":"Shiffman\n \nML\n,","year":"1993"},{"issue":"(5):","key":"CIT0026","series-title":"Hepatology","first-page":"1138\u20131143","article-title":"Genetic and environmental influences on symptomatic gallstone disease: a Swedish study of 43,141 twin pairs","volume":"41","author":"Katsika\n \nD\n,","year":"2005"},{"issue":"(2):","key":"CIT0027","series-title":"Gastroenterol Clin North Am","first-page":"265\u2013287","article-title":"Gallbladder Imaging","volume":"39","author":"Gore\n \nRM\n,","year":"2010"},{"issue":"2018:","key":"CIT0028","series-title":"Can J Gastroenterol Hepatol","first-page":"6962090","article-title":"Mirizzi syndrome: diagnosis and management of a challenging biliary disease","author":"Clemente\n \nG\n,","year":"2018"},{"issue":"(2):","key":"CIT0029","series-title":"Ann Hepatobiliary Pancreat Surg","first-page":"67\u201375","article-title":"Mirizzi syndrome: a new insight provided by a novel classification","volume":"21","author":"Pay\u00e1-Llorente\n \nC\n,","year":"2017"},{"issue":"(4):","key":"CIT0030","series-title":"Endoscopy","first-page":"S229","article-title":"The first experience of indirect peroral cholangio-pancreatoscopy using the spyglass DS system (BSC) in Russia","volume":"51","author":"Bakhtiozina\n \nD\n,","year":"2019"},{"issue":"(4):","key":"CIT0031","series-title":"Turk J Surg","first-page":"399\u2013404","article-title":"Mirizzi syndrome from type I to Vb: a single center experience","volume":"36","author":"Gonzalez-Urquijo\n \nM\n,","year":"2020"},{"issue":"(4):","key":"CIT0032","series-title":"Cureus","first-page":"e37029","article-title":"Mirizzi syndrome type I: a case presentation","volume":"15","author":"Won\n \nMN\n,","year":"2023"},{"key":"CIT0033"},{"key":"CIT0034","author":"Jones\n \nDB\n,"},{"key":"CIT0035","author":"Akbarov\n \nMM\n,"},{"issue":"(3):","key":"CIT0036","series-title":"Am J Surg","first-page":"385\u2013387","article-title":"The European experience with laparoscopic cholecystectomy","volume":"161","author":"Cuschieri\n \nA\n,","year":"1991"},{"issue":"(4):","key":"CIT0037","series-title":"J Laparoendosc Surg","first-page":"157\u2013163","article-title":"Laparoscopic surgery in the treatment of Mirizzi's syndrome","volume":"2","author":"Paul\n \nMG\n,","year":"1992"},{"issue":"(1):","key":"CIT0038","series-title":"Surg Endosc","first-page":"33\u201339","article-title":"Laparoscopic treatment of Mirizzi syndrome: a systematic review","volume":"24","author":"Antoniou\n \nSA\n,","year":"2010"},{"issue":"(45):","key":"CIT0039","series-title":"Medicine (Baltimore)","first-page":"e22649","article-title":"Novel peroral cholangioscopy-directed lithotripsy using an ultraslim upper endoscope for refractory Mirizzi syndrome: a case report","volume":"99","author":"Li\n \nJ\n,","year":"2020"},{"issue":"(4):","key":"CIT0040","series-title":"World J Gastrointest Surg","first-page":"43\u201348","article-title":"Classification and management of bile duct injuries","volume":"3","author":"Mercado\n \nMA\n,","year":"2011"},{"key":"CIT0041"},{"issue":"(1):","key":"CIT0042","series-title":"J Laparoendosc Adv Surg Tech A","first-page":"28\u201332","article-title":"Management of Mirizzi syndrome in emergency","volume":"27","author":"Testini\n \nM\n,","year":"2017"},{"issue":"(3):","key":"CIT0043","series-title":"Khirurgiia (Mosk)","first-page":"42-47","article-title":"[Mirizzi syndrome management (in Russian only)]","author":"Pugaev\n \nAV.\n,","year":"2019;"},{"issue":"(7):","key":"CIT0044","series-title":"Br J Surg","first-page":"743\u2013745","article-title":"Management of the Mirizzi syndrome and the surgical implications of cholecystcholedochal fistula","volume":"77","author":"Baer\n \nHU\n,","year":"1990"},{"issue":"(6):","key":"CIT0045","series-title":"J Gastrointest Surg","first-page":"1631\u20131932","article-title":"A case of Mirizzi syndrome with erosion into the common hepatic duct","volume":"25","author":"Zhang\n \nJ\n,","year":"2021"},{"issue":"(5):","key":"CIT0046","series-title":"Surg Endosc","first-page":"2215\u20132222","article-title":"Complicated gallstone disease: diagnosis and management of Mirizzi syndrome","volume":"31","author":"Kulkarni\n \nSS\n,","year":"2017"},{"issue":"(1):","key":"CIT0047","series-title":"Korean J Hepatobiliary Pancreat Surg","first-page":"17\u201322","article-title":"Mirizzi's syndrome: lessons learnt from 169 patients at a single center","volume":"20","author":"Kumar\n \nA\n,","year":"2016"},{"issue":"(4):","key":"CIT0048","series-title":"J Minim Access Surg","first-page":"246\u2013250","article-title":"Laparoscopic approach is safe and effective in the management of Mirizzi syndrome","volume":"11","author":"Kamalesh\n \nNP\n,","year":"2015;"},{"issue":"(9):","key":"CIT0049","series-title":"Surg Endosc","first-page":"1477\u20131481","article-title":"Mirizzi syndrome: laparoscopic management by subtotal cholecystectomy","volume":"20","author":"Rohatgi\n \nA\n,","year":"2006"},{"key":"CIT0050","series-title":"Case Reports Hepatol","first-page":"6434507","article-title":"Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy by tri-staple in a type V Mirizzi syndrome","author":"Yeti\u015fir\n \nF\n,","year":"2016;"},{"issue":"(1):","key":"CIT0051","series-title":"Ann Gastroenterol Dig Syst [online]","first-page":"1026","article-title":"Diagnosis and treatment of Mirizzi syndrome: case report and literature review","volume":"3","author":"Sanchez\n \nGarcia NL\n,","year":"2020"},{"issue":"14:","key":"CIT0001","series-title":"BMC Surg","first-page":"90","article-title":"Acute acalculous cholecystitis determining Mirizzi syndrome: case report and literature review","author":"Milone\n \nM\n,","year":"2014"},{"issue":"27:","key":"CIT0002","series-title":"Pan Afr Med J","first-page":"45","article-title":"Le syndrome de Mirizzi: une cause rare de l'obstruction des voies biliaires: \u00e0 propos d'un cas et revue de litt\u00e9rature","author":"Bellamlih\n \nH\n,","year":"2017"},{"issue":"(4):","key":"CIT0003","series-title":"Acta Gastroenterol Latinoam","first-page":"323\u2013328","article-title":"S\u00edndrome de Mirizzi: Prevalencia, diagn\u00f3sticoy tratamiento [Mirizzi Syndrome: Prevalence, diagnosis and treatment]","volume":"44","author":"Acquafresca\n \nP\n,","year":"2014;"},{"key":"CIT0004","author":"Jones\n \nMW\n,"},{"issue":"1:","key":"CIT0005","series-title":"Surg Gastroenterol","first-page":"219\u2013225","article-title":"The Mirizzi Syndrome: Suggested Classification and Surgical Therapy","author":"McSherry,\n \nC.K.\n,","year":"1982;"},{"issue":"(34):","key":"CIT0006","series-title":"World J Gastroenterol","first-page":"4639\u20134650","article-title":"Mirizzi syndrome: history, current knowledge and proposal of a simplified classification","volume":"18","author":"Beltr\u00e1n\n \nMA","year":"2012"},{"issue":"(11):","key":"CIT0007","series-title":"Br J Surg","first-page":"1139\u20131143","article-title":"Mirizzi syndrome and cholecystobiliary fistula: a unifying classification","volume":"76","author":"Csendes\n \nA\n,","year":"1989"},{"issue":"(10):","key":"CIT0008","series-title":"World J Surg","first-page":"2237-2243","article-title":"The relationship of Mirizzi syndrome and cholecystoenteric fistula: validation of a modified classification","volume":"32","author":"Beltran\n \nMA\n,","year":"2008"},{"issue":"(9):","key":"CIT0009","series-title":"Diagnostics (Basel)","first-page":"1660","article-title":"The Current approach to the diagnosis and classification of Mirizzi syndrome","volume":"11","author":"Klekowski\n \nJ\n,","year":"2021"},{"issue":"(10):","key":"CIT0010","series-title":"ANZ J Surg","first-page":"708\u2013713","article-title":"Appraisal of diagnosis and surgical approach for Mirizzi syndrome","volume":"82","author":"Cui\n \nY\n,","year":"2012"},{"issue":"(3):","key":"CIT0011","series-title":"Gastrointest Radiol","first-page":"265\u2013228","article-title":"Mirizzi syndrome and biliobiliary fistulas: roentgenologic appearance","volume":"6","author":"Cornud\n \nF\n,","year":"1981;"},{"issue":"(2):","key":"CIT0012","series-title":"Am J Gastroenterol","first-page":"249\u2013254","article-title":"Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus","volume":"97","author":"Abou-Saif\n \nA\n,","year":"2002"},{"issue":"(4):","key":"CIT0013","series-title":"Medicine (Baltimore)","first-page":"e9691","article-title":"Current trends in the management of Mirizzi syndrome: a review of literature","volume":"97","author":"Chen\n \nH\n,","year":"2018"},{"issue":"(3):","key":"CIT0014","series-title":"Surg Laparosc Endosc Percutan Tech","first-page":"248\u2013252","article-title":"A minimally invasive strategy for Mirizzi syndrome type II: Combined endoscopic with laparoscopic approach","volume":"26","author":"Yuan\n \nH\n,","year":"2016"},{"issue":"(5):","key":"CIT0015","series-title":"Pak J Med Sci","first-page":"1275\u20131279","article-title":"Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction \u2013 finding a better diagnostic tool","volume":"39","author":"Khan\n \nRSA\n,","year":"2023"},{"issue":"5:","key":"CIT0016","series-title":"Int Semin Surg Oncol","first-page":"12","article-title":"Mirizzi syndrome: an unexpected problem of cholelithiasis. Our experience with 27 cases","author":"Safioleas\n \nM\n,","year":"2008"},{"issue":"(3):","key":"CIT0017","series-title":"Laparosc Endosc Robot Surg","first-page":"85\u201391","article-title":"Robotic-assisted cholecystectomy: current status and future application","volume":"5","author":"Chandhok\n \nS\n,","year":"2022"},{"issue":"(1):","key":"CIT0018","series-title":"J Am Coll Surg","first-page":"114\u2013119; discussion 120-1","article-title":"Diagnosis and treatment of Mirizzi syndrome: 23-year Mayo Clinic experience","volume":"213","author":"Erben\n \nY\n,","year":"2011"},{"issue":"(3):","key":"CIT0019","series-title":"Ann Hepatobiliary Pancreat Surg","first-page":"122\u2013130","article-title":"Mirizzi syndrome: necessity for safe approach in dealing with diagnostic and treatment challenges","volume":"21","author":"Shirah\n \nBH\n,","year":"2017"},{"issue":"(4):","key":"CIT0020","series-title":"Semin Intervent Radiol","first-page":"332\u2013336","article-title":"Biliary interventions: delayed diagnosis of Mirizzi syndrome","volume":"33","author":"Oladini\n \nO\n,","year":"2016"},{"issue":"(1):","key":"CIT0021","series-title":"Ann Surg","first-page":"59\u201363","article-title":"The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients","volume":"202","author":"Mcsherry\n \nCK\n,","year":"1985"},{"issue":"(1):","key":"CIT0022","series-title":"Medicina (Kaunas)","first-page":"12","article-title":"Mirizzi syndrome\u2014the past, present, and future","volume":"60","author":"Koo\n \nJGA\n,","year":"2023"},{"issue":"(2):","key":"CIT0023","series-title":"Gastroenterology","first-page":"508\u2013516","article-title":"Gallstone disease is associated with increased mortality in the United States","volume":"140","author":"Ruhl\n \nCE\n,","year":"2011"},{"issue":"(2):","key":"CIT0024","series-title":"Gut Liver","first-page":"172\u2013187","article-title":"Epidemiology of gallbladder disease: cholelithiasis and cancer","volume":"6","author":"Stinton\n \nLM\n,","year":"2012"},{"issue":"(3):","key":"CIT0025","series-title":"Int J Obes Relat Metab Disord","first-page":"153\u2013158","article-title":"Gallstones in patients with morbid obesity. Relationship to body weight, weight loss and gallbladder bile cholesterol solubility","volume":"17","author":"Shiffman\n \nML\n,","year":"1993"},{"issue":"(5):","key":"CIT0026","series-title":"Hepatology","first-page":"1138\u20131143","article-title":"Genetic and environmental influences on symptomatic gallstone disease: a Swedish study of 43,141 twin pairs","volume":"41","author":"Katsika\n \nD\n,","year":"2005"},{"issue":"(2):","key":"CIT0027","series-title":"Gastroenterol Clin North Am","first-page":"265\u2013287","article-title":"Gallbladder Imaging","volume":"39","author":"Gore\n \nRM\n,","year":"2010"},{"issue":"2018:","key":"CIT0028","series-title":"Can J Gastroenterol Hepatol","first-page":"6962090","article-title":"Mirizzi syndrome: diagnosis and management of a challenging biliary disease","author":"Clemente\n \nG\n,","year":"2018"},{"issue":"(2):","key":"CIT0029","series-title":"Ann Hepatobiliary Pancreat Surg","first-page":"67\u201375","article-title":"Mirizzi syndrome: a 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