A case of Mirizzi's syndrome with abnormal branched cystic duct managed by extracorporeal shock wave lithotripsy and endoscopic sphincterotomy

We report a case of Mirizzi's syndrome managed by extracorporeal shock wave lithotripsy and endoscopic sphincterotomy. An 84-year-old man who was suspected of choledocholithiasis but preferred non surgical treatment was transfered to our hospital. The stone impacted in the dilated cystic duct was removed by endoscopic sphincterotomy after fragmentation by extracorporeal shock wave lithotripsy. Endoscopic retrograde cholangiography revealed that the dilated cystic duct branched into the lower common hepatic duct. Long-term results should be assessed carefully, but extracorporeal shock wave lithotripsy in combination with endoscopic sphincterotomy for Mirizzi's syndrome should be actively attempted because it is a non-invasive and effective technique

Laparoscopic cholecystectomy in 3 cases of hemodialysis patients

Laparoscopic cholecystectomy has proven to be a safe and effective treatment for symptomatic gall stone disease. However, laparoscopic cholecystectomy in hemodialysis patients is considered to be relatively contraindicated because of anemia and bleeding tendency. We performed laparoscopic cholecystectomy in three patients being treated by hemodialysis for chronic renal failure. No significant complications were observed after surgery. Laparoscopic cholecystectomy should be considered for hemodialysis patients requiring cholecystectomy