Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mirizzi syndrome is estimated to occur in about 1% of cases requiring urgent or elective biliary tract surgery. The key anatomic finding is extrinsic compression of the common duct by a stone located in the gallbladder or cystic duct. Among patients operated on in the last 12 years we have found 77 patients meeting criteria to diagnose Mirizzi syndrome. 76% were females, usually over 40 years of age; jaundice was present in 98% and elevated alkaline phosphatase in 97% of cases. Percutaneous transhepatic cholangiography allowed the diagnosis in 32 of 41 patients. The most common surgical technique involved a patch repair of the gallbladder over the Kehr tube in 45 patients. Eight patients required biliary-jejunal bypass. Eleven patients were reoperated on for benign stenosis of the biliary tract over a 1 month to 10 year period of follow up.
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PMID:[Mirizzi syndrome: experience of 77 cases]. 251 60

Fourteen cases of Mirizzi's syndrome are presented here. Clinical presentation was pain (14), jaundice (14), fever (10) and peritonitis (1). A clinical diagnosis of choledocholithiasis was considered in all the patients. Pre-operative diagnosis of Mirizzi's syndrome was made in five patients on the basis of cholangiogram and the remaining cases were diagnosed at surgery. The stage (type) of Mirizzi's syndrome was based on the extent of erosion of the common bile duct. Four patients had type I, seven type II and three type III lesions. Associated choledocholithiasis was present in five and acute free perforation of the gall-bladder in one. The operative procedures performed were partial cholecystectomy for type I, partial cholecystectomy, choledochoplasty and T-tube choledochostomy for type II and bilioenteric anastomosis for type III lesions. Two patients had retained common bile duct stones. Mean follow up was 14 months (range 1-27 months). One patient with secondary biliary cirrhosis continues to have persistently elevated serum alkaline phosphatase levels without any demonstrable biliary obstruction. Diagnostic and operative strategies are discussed and a follow up protocol for such patients is suggested.
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PMID:Mirizzi's syndrome: identification and management strategy. 827 24