腹腔镜在Mirizzi综合征手术中的应用

Laparoscopic treatment of mirizzi syndrome

目的探讨腹腔镜治疗Mirizzi综合征的手术方法和效果。方法回顾分析腹腔镜胆囊切除术(LC)治疗Mirizzi综合征46例的临床资料。结果34例仔细解剖胆囊管上钛夹后切除胆囊,4例切断胆囊壶腹,残端用纤维蛋白胶+明胶海绵封闭,5例行胆囊部分切除术,残端用可吸收缝合线缝合关闭,3例中转开腹胆总管探查T管引流。术后5例出现胆瘘,引流1～3周胆瘘停止,拔除腹腔引流管痊愈。结论在腹腔镜下手术或及时中转开腹手术,Mirizzi综合征均能达到良好的治疗效果。

[Objective] To discuss laparoscopic treatment of Mirizzi syndrome and its effects. [Methods] Analyse 46 cases Mirizzi syndrome treated by LC retrospectively. [Results] 34 cases of choecystectomies after finding cystic duct carefully and taking up it by titanium clip, 4 cases cut in the neck of gallbladder and solved the remainder by gelatin sponge and fibrin glue, partial cholecystectomies in 5 cases and closed the remainder by soluble suture, turning to open operation with common bile duct exploration and ＂ T＂ tube drainage in 3 cases. Among them, pastoperative bile leakage occurred in 5 cases and cured by drainage of abdominal cavity after 1-3 weeks. [Conclusion] We can gain satisfied clinic effects by laparoscopie treatment or turning to open operation in time in the treatment of Mirizzi syndrome.