手术治疗Mirizzi综合征21例报告

Surgical Treatment of Mirizzi Syndrome: A Report of 21 Cases

目的探讨胆囊结石并发Mirizzi综合征的诊断和手术方式。方法1995年5月-2005年5月收治Mirizzi综合征21例，采用手术治疗，手术方式为单纯胆囊切除6例，余15例加行以下手术：T管引流3例，胆管瘘口修补7例（其中2例瘘口较大，采用残余胆囊壁修复胆总管，另切开正常胆总管壁行T管引流），胆道损伤整形修补加胆管探查T管引流术3例，胆总管空肠Roux-en-Y吻合1例，胆总管外引流后Ⅱ期行胆总管空肠盆式吻合术l例。结果术后发生胆漏3例，经腹腔引流3—14d后治愈，无其他严重并发症。结论对病程长，多年反复发作的胆囊结石并发不同程度的梗阻性黄疸和胆管炎者应考虑Mirizzi综合征的可能。处理时按各类型的特殊性作相应的手术处理，可获得良好效果。

Objective To study the diagnosis and surgical treatment for Mirizzi syndrome. Methods 21 cases of Mirizzi syndrome from May 1995 to May 2005 were surgically treated, including simple cholecystectomy in 6 cases, cholecystectomy plus T-tube drainage in 3 cases, fistula repair in 7 cases, bile ductal plasty plus T-tube drainage in 3 cases, Roux-en-Y choledochojejunostomy in 1 case, hilar-enteric anastomosis following extra drainage in l case. Result There were occurrences of bile leakage in 3 cases which were cured by drainage for 3 to 14 days. Conclusions MMzzi syndrome should be considered for the case with long-lasting, recurrent gallbladder stone complicated with jaundice and cholangitis. Surgical treatment can be varied from case to case.