Mirizzi综合征的诊断和治疗

目的　探讨Mirizzi综合征的病因 ,诊断及治疗方法。方法　对 19例Mirizzi综合征病人资料进行回顾性分析。结果　 9例术前确诊 ,确诊率 4 7.4 %。 10例急诊剖腹探查 ,3例误诊为胆囊癌 ,2例误诊为胆管癌 ,术中误诊率 5 0 .0 % ;8例行胆囊或胆总管引流 ,二期手术切除胆囊治愈 ,再手术率4 2 .1%。结论　胆囊管解剖结构异常不是Mirizzi综合征的主要原因 ;胆囊结石或嵌顿也不是此征的唯一原因 ,及时手术切除胆囊和解除胆道梗阻是治愈的首选方法。

Clinical diagnosis and treatment of Mirizzi syndrome

To explore pathogenosis,diagnosis and treating procedure.Methods The data of 19 patients with Mirizzi syndrome were analysed retrospectively.Results Among the 19 patients,9 were diagnosed definitely before operation,confirmed diagnostic rate was 47.4%.Emergency laparotomy was made in 10 patients,of which 3 were misdianostic as cholecystic carcinoma and 2 as bile duct cancer,the misdiagnostic rate was 50.0% intraoperatively,8 were cured in secondary operation,reoperative rate was 42.1%.All 19 patients were cured.Conclusion The anatomical deformity of cholecystic duct is not major cause of Mirizzi syndrome,nor cholecystic stone or stone obstruction is only cause.For saving and curing the patients first choice measures is to relieve obstruction of biliary duct and make cholecystomy timely.