Mirizzi syndrome: History, current knowledge and proposal of a simplified classification

Figure 5 Mirizzi syndrome type I to type V. A: Mirizzi type I is the extrinsic compression of the common bile duct by an impacted gallstone; B: Mirizzi type II consists of a cholecystobiliary fistula involving one third of the circumference of the bile duct; C: In Mirizzi type III, the cholecystobiliary fistula compromises up to two-thirds of the circumference of the bile duct; D: In Mirizzi type IV, the cholecystobiliary fistula has destroyed the bile duct wall, and comprises the whole circumference of the bile duct; E: Mirizzi type V corresponds to any type of Mirizzi associated with a bilioenteric fistula with or without gallstone ileus (original drawings from World Journal of Surgery 2008; 32, pages 2239 to 2241)[4].