Mirizzi综合征19例临床分析

Clinical analysis of 19 patients with Mirizzi syndrome

目的总结Mirizzi综合征(MS)的诊断治疗经验。方法对19例MS患者的临床资料进行回顾性分析。结果19例中术前确诊2例。余17例均为术中确诊,其中在腹腔镜手术中发现MS3例,中转开腹1例。依病理损伤程度,术中分别行胆囊切除术、胆囊大部分切除术、瘘口直接修补术、带血管蒂胆囊瓣修补瘘口术及RouxenY胆肠吻合术等手术治疗。术后患者均临床治愈。结论MS术前诊断较困难,提高对本病的认识有重要的意义。对不同病理类型的MS应采取不同的手术方法。腹腔镜下治疗MS是可行的。

Objective To summarize experience of diagnosis and treatment of Mirizzi syndrome(MS).Methods Nineteen patients with MS diagnosed through operation were analyzed retrospectively.Results Only 2 patients were diagnosed preoperatively.Three patients were diagnosed during the laparocopy,in which 1 case was changed to open abdomen operation.On the basis of pathological injury degree,variant operative methods were adopted such as cholecystectomy,subtotal cholecystectomy,direct repair of biliary duct fistula,repair of bile duct fistula with vascularized gallbladder graft and Roux-en-Y cholangiojejunostomy.All the patients were cured after the operation.Conclusion Diagnosis of MS preoperatively is very difficult,so it is very important to enhance recognition about this special disease. Different operative procedures should be used according to patientsˊpathologic type.It is feasible to treat MS through laparoscopic surgery.