Mirizzi综合征诊治体会

目的探讨Mirizzi综合征的诊断与治疗特点,提高其诊治水平。方法对经手术证实的17例Mirizzi综合征患者的临床资料进行回顾分析。结果17例Mirizzi综合征患者中仅1例(5.88%)术前确诊。术式选择分别为胆囊切除术9例(52.94%),胆囊大部分切除术4例(23.53%),胆囊切除、胆总管探查、瘘口修补、T管外引流术3例(17.65%),胆囊切除、胆总管探查、胆肠内引流术1例(5.88%)。17例中4例由于腹腔镜手术中解剖困难、出血,中转开腹。结论Mirizzi综合征术前诊断困难,治疗上应根据不同类型选择适当的手术方式,腹腔镜不宜为Mirizzi综合征的适应证。

Experience in diagnosis and treatment of 17 cases with Mirizzi's syndrome

Objective To explore the characteristics of the diagnosis and treatment in patients with Mirizzi's syndrome (MS),to improve the level of the diagnosis and treatment of MS. Methods Clinical data from 17 cases with surgically proved MS were retrospectively analyzed. Results The results revealed that the diagnosis before operation was made only in 1 case (5.88%). Of the 17 cases,9 (52.94%) were treated with cholecystectomy,4 (23.53%) with partial cholecystectomy,3 (17.65%) were treated with Cholecystectomy,the bile duct were repaired and the T shape tube were drainaged in the bile duct,1 (5.88%) was treated with Roux-Y hepaticojejunostomy. 4 of the 17 cases were changed operation method when they were Laparoscopic Chole cystectomy (LC). Conclusions It was difficulty to diagnose MS before operation. Appropriate operative patterns should be selected according to different types of MS. LC is not a proper method to MS.