三镜联合治疗Mirizzi综合征106例

目的探讨三镜联合治疗Mirizzi综合征的手术方法及疗效。方法回顾分析2001年2月至2011年6月106例Mirizzi综合征患者的临床资料，联合腹腔镜、胆道镜、十二指肠镜实行腹腔镜下胆囊切除、胆总管切开，胆道镜探查取石术，乳头括约肌切开术，总结各种手术方式。结果按Csendes分型，Ⅰ型58例，Ⅱ型32例，Ⅲ型11例，Ⅳ型5例。根据患者不同情况在腹腔镜下分别行胆囊切除、瘘口修补或胆囊大部切除、胆管修复、胆道探查术、乳头括约肌切开取石术、T管引流术。术后发生胆漏2例，轻症胰腺炎1例。结论三镜联合治疗Mirizzi综合征是切实可行和安全可靠的。

A study on combination operation of laparoscopy,choledochoscopy and duodenoscopy treat Mirizzisyndrome:a report of 106 cases

Objective To investigate the effect and method of combination operation of laparoscopy,choledochoscopy and duodenoscopy treatment of Mirizzi syndrome.Methods To retrospectively analyze clinical data of 106 cases with Mirizzi syndrome from February 2001 to June 2011,applied laparoscopy,choledochoscopy and duodenoscopy to accomplish laparoscopic cholecystectomy,laparoscopic common bile duct exploration,laparoscopic and endoscopic sphincterotomy then make a summary of different operating methods.Results To differentiate the patterns of all patients by Csendes standard,pattern Ⅰ for 58 cases,pattern Ⅱ for 32 cases,pattern Ⅲ for 11 cases,pattern Ⅳ for 5 cases.All 106 patients endured cholecystectomy,fistula reparation,or mostpart-cholecystectomy,bile track reconstruction,laparoscopic common bile duct exploration,laparoscopic and endoscopic cholelithotomy,T-tube drainage according to the actual different situation by laparoscopy.There were two bile leakage cases after operation and one slight pancreatitis case.Conclusions It is feasible and safe that we use laparoscopy,choledochoscopy and duodenoscopy treatment of Mirizzi syndrome.