Introduction:

The Mirizzi syndrome (SM) is used to describe the mechanical obstruction of the common hepatic duct due to extrinsic compression (with or without associated fistula). It occurs in approximately 0.2 to 1.5% of patients with cholelithiasis. The continued inflammation of the gallbladder can evolve into a compression and fusion to adjacent viscera like colon and duodenum. Patients have a long history of gallstone disease and symptoms that are nonspecific. The goals of treatment are to decompress the bile duct and prevent recurrence. Surgical treatment is based on the classification of Beltran and Culture of Safety in Cholecistectomy (COSIC) principles.

Case report:

We present the case of a patient scheduled for laparoscopic cholecystectomy for cholelithiasis, where conversion to open by the major bile inflammatory fusion to colon and duodenun and misidentification of structures, managed with a cholecystostomy tube, in order to, later planning definitive surgical treatment.

Conclusion:

The case presented with compression of the gallbladder and inflammatory biliary fusion colon duodenum and bile ducts is a variant of SM that is not described by the rarity of presentation we propose to add to the classification of Beltran SM type Ia and Ib to reduce the risk of vasculobiliar and intestinal by principles of COSIC we recommending colcistostomy as surgical treatment for type Ib SM.