Mirizzi综合征19例诊治分析

目的探讨Mirizzi综合征诊断要点及其各型病例的手术方式选择.方法对自1985年以来收治的19例Mirizzi综合征的诊断和治疗进行回顾性研究.结果19例中术前诊断仅4例,余15例均术中证实为Mirizzi综合征.19例中根据病理损伤程度,分别采用了胆囊切除术、保留胆囊颈的胆囊大部分切除术、瘘口直接修补术、利用保留胆囊瓣修补瘘口术及Rouxen-y胆肠吻合术等不同手术治疗.各种手术后的患者全部临床治愈.结论Mirizzi综合征的术前或术中诊断甚为重要,依靠术者的经验积累和耐心细致的操作,根据病理损伤程度采用合理的手术方式,预后良好.

Diagnosis and treatment of Mirizzi''''s syndrome: Analysis of 19 cases

AIM To expleore how to diagnose and choice Surgical management of several Mirizzi's syndrome. METHODS 19 patients with Mirizzi's syndrome diagnosed and treated in our hospital from 1985 to now were analyzed retrospectively. RESULTS Only 4 cases were diagnosed preoperatively and 15 cases were diagnosed intraoperative among 19 cases of Mirizzi's syndrome on the basis of pathological injury degree imparyty, choice of variant operatice method such as cholecystectomy, partical cholecystectomy remain cholecystic neck, fistula of biliary duct direct mended operation, fistula mended with cholecystic flap operation, Roux-en-y cholangioenterstomy. All the patients were cured after the operative tredtment. CONCLUSION Diagnosis of Mirizzi's syndrome preoperatively or intraoperative is very difficultly, but very important. It is better prognosis by careful and skilled operators and reasonable operative method to be chose by pathological injury degree.