腹腔镜手术治疗Mirizzi综合征分析

Laparoscopic Management for Mirizzi Syndrome

目的探讨腹腔镜下Mirizzi综合征(MS)手术适应证及手术方法。方法回顾性分析腹腔镜下治疗的14例Mirizzi综合征的手术方法和疗效。结果14例全部采用腹腔镜手术治疗,手术方式包括胆囊切除术7例,胆囊大部分切除术3例,胆囊切除或胆囊部分切除直接修补瘘口放置T管4例。腹腔镜术后14例均获随访,随访时间为1～3年,无明显手术并发症。结论Mirizzi综合征的术前和术中诊断及分型直接关系到手术适应症及手术方法的选择。在熟练掌握腹腔镜技术的前提下腹腔镜治疗Mirizzi综合征的I型和Ⅱ型是安全可行的方法。

Objective To evaluate the surgical indication and approach of laparoscopic treatment of Mirizzi syndrome. Methods The laparoscopic approach and therapeutic effect in 14 cases with Mirizzi syndrome were analyzed retrospectively. Results Fourteen cases underwent Laparoscopia cholecystectomy including cholecystectorny in 7 cases,partial ebolecystectomy in 3 cases and cholecystectomy or partial cholecystectomy plus commen bile duct exploration with T-tube drainage in 4 cases.All cases were followed up h-ore 1 years to 3 years after treatment.No surgery related complications occurred. Conclusion The increase in the diagnostic rate and the type of Mirizzi syndrome in preoperation or operation are directly related to the surgical indication and the choice of therapy approach. Laparoscopie management of Mirizzi syndrome type Ⅰ and Ⅱis feasible and safe when ]aparoscopy can be skillfully used.