Mirizzi综合征中医源性胆道损伤的处理 |
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引用本文: | 龚伟智,刘昌军,朱朝庚,毛先海,周海兰,吴金术.Mirizzi综合征中医源性胆道损伤的处理[J].医学临床研究,2011,28(5):868-870. |
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作者姓名: | 龚伟智 刘昌军 朱朝庚 毛先海 周海兰 吴金术 |
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作者单位: | 湖南省人民医院肝胆外科,湖南,长沙,410005 |
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摘 要: | 【目的】探讨Mirizzi综合征的诊断及减少术中医源性胆管损伤的处理措施。【方法】回顾分析43例Mirizzi综合征患者诊断、分型、手术方法等临床资料。【结果143例Mirizzi综合征术前确诊25例,术中损伤胆管9例,占20.93%。【结i~]Mirizzi综合征是胆道外科手术中致胆管损伤的主要因素;ERCP、MRCP是诊断该病的主要检查方法;对术前确诊及高度怀疑此病的患者,开腹行胆囊切除、胆管修补或胆肠Roux-en-Y吻合术安全、可行。
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关 键 词: | 胆管炎 胆结石 胆汁郁积 肝内 |
Treatment of Iatrogenic Bile Duct Injury in Mirizzi Syndrome |
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Institution: | GONG Wei-zhi , LIU Chang-jun, ZHU Chao-geng, et al (Department of Genneral Surgery, Hunan Provincial People's Hospital, Changsha 410005, China ) |
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Abstract: | Objective]To explore the diagnosis of Mirizzi syndrome and the treatment method of reducing iatrogenic bile duct injury during surgery. MethodslThe clinical data such as diagnosis, clinical type and sur- gical method of 43 patients with Mirizzi syndrome were analyzed retrospectively. Restilts]Mirizzi syndrome was definitely diagnosed before operation in 25 of the 43 patients and 9 patients(20.93 %) suffered intraopera- tive bile duct injury. Conclusion]Mirizzi syndrome is the main cause of bile duct injury in biliary surgery. ER- CP and MRCP are the main diagnosis methods of the disease. Open cholecystectomy, bile duct repair or cholangio-jejunal Roux-en-Y anastomosis for the treatment of the patients who are definitely diagnosed before operation or highly suspected of Mirizzi syndrome are safe and feasible. |
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Keywords: | cholangitis cholelithiasis cholestasis intrahepatic |
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