Mirizzi's syndrome is characterized by compression and/or stenosis of the common bile duct as a consequence of a stone impaction in the cystic duct or in the gallbladder neck. Clinical outcome, diagnostic pathway and operative management in 27 patients are presented. Ultrasound is referred as the first screening method, while E.R.C.P. and/or percutaneous transhepatic cholangiography allow to confirm the diagnosis. Surgical approach is considered to be of choice and technical expedients are suggested to prevent intraoperative damage and to repair defects of the common bile duct.

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