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Mirizzi综合征中医源性胆道损伤的处理
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.
作者姓名:龚伟智  刘昌军  朱朝庚  毛先海  周海兰  吴金术
作者单位:湖南省人民医院肝胆外科,湖南,长沙,410005
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。

关 键 词:胆管炎  胆结石  胆汁郁积  肝内

Treatment of Iatrogenic Bile Duct Injury in Mirizzi Syndrome
Institution:GONG Wei-zhi , LIU Chang-jun, ZHU Chao-geng, et al (Department of Genneral Surgery, Hunan Provincial People's Hospital, Changsha 410005, China )
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.
Keywords:cholangitis  cholelithiasis  cholestasis  intrahepatic
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