Mirizzi综合征的临床诊治研究

The Study on Diagnosis and Treatment of Mirizzi Syndrome

目的探讨Mirizzi综合征的诊断治疗特点,提高诊断治疗水平。方法对1995年5月￣2006年8月经手术证实的Mirizzi综合征35例的临床资料作回顾性分析。结果35例Mirizzi综合征中仅1例(2.86%)术前确诊。35例中行胆囊切除术11例(31.43%),胆囊大部分切除术3例(8.57%),胆囊切除、胆囊瓣瘘口修补术5例(14.29%),胆囊切除胆总管探查、瘘口修补、"T"管引流术15例(42.86%),胆囊切除、胆总管切开取石、Roux-en-Y胆肠吻合术1例(2.86%)。结论Mirizzi综合征术前确诊困难,术中易损伤胆管。B超和ERCP检查相结合可提高术前确诊率,手术方式应根据病理损伤程度决定。

Objective To explore the characteristics of the diagnosis and treatment in patients with Mirizzi syndrome,and improve the diagnosis and treatment of MS. Methods The clinical data of 35 ease with MS proved by operation from May 1995 to August 2006 were retrospectively analyzed. Results The diagnosis before operation was made only in 1 ease （2.86%）. Of the 35 eases,lleases （31.43%）were treated with eholecyteeomy, 3 eases （8.57%）were. treated with partial eholeeystecomy, 5 eases （14.29%）were treated with eholecyteeomy and choledochoplasty with remnant of the gallbladder, 15 cases （42.86%）were treated with choleeyteeomy and suture closure of the gallbladder, 1 case（ 2.86% ）was treated with Roux-en-Y hepatieojejunostomy. Conclusion It is dittficult to diagnosie before operation and it is easy to damage the bile duet during operation. Preoperative diagnosis rate can be improved by taking ultrasnography and ERCP examination. The surgical procedure must be decided according to the pathological condition.