Mirizzi syndrome is a rare cause of obstructive jaundice in which a gallstone impacts in Hartmann's pouch or the cystic duct and extrinsically compresses the common hepatic duct. The McSherry classification Type II includes:

• A Extrinsic compression of the CHD without cholecystocholedochal fistula (Type I)
• B Complete destruction of the CHD with fistula eroding >two-thirds of the circumference
• C Cholecystocholedochal fistula eroding less than one-third of the circumference of the CHD ✓
• D Gallstone cholangitis without choledochal involvement

Explanation

Mirizzi syndrome McSherry/Csendes classification: Type I — extrinsic compression of CHD without fistula; Type II — cholecystocholedochal fistula involving <1/3 of the CHD circumference; Type III — fistula involving 1/3–2/3 of CHD; Type IV — fistula involving >2/3 of CHD (complete destruction). Type I is managed by cholecystectomy; Type II–III by partial cholecystectomy + choledochoplasty; Type IV may require hepaticojejunostomy. Knowing the classification guides the extent of biliary reconstruction needed.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.