Mirizzi综合征中医源性胆道损伤的处理

Treatment of Iatrogenic Bile Duct Injury in Mirizzi Syndrome

【目的】探讨Mirizzi综合征的诊断及减少术中医源性胆管损伤的处理措施。【方法】回顾分析43例Mirizzi综合征患者诊断、分型、手术方法等临床资料。【结果143例Mirizzi综合征术前确诊25例，术中损伤胆管9例，占20．93％。【结i~]Mirizzi综合征是胆道外科手术中致胆管损伤的主要因素；ERCP、MRCP是诊断该病的主要检查方法；对术前确诊及高度怀疑此病的患者，开腹行胆囊切除、胆管修补或胆肠Roux-en-Y吻合术安全、可行。

[Objective]To explore the diagnosis of Mirizzi syndrome and the treatment method of reducing iatrogenic bile duct injury during surgery. [MethodslThe clinical data such as diagnosis, clinical type and sur- gical method of 43 patients with Mirizzi syndrome were analyzed retrospectively. [Restilts]Mirizzi syndrome was definitely diagnosed before operation in 25 of the 43 patients and 9 patients（20.93 %） suffered intraopera- tive bile duct injury. [Conclusion]Mirizzi syndrome is the main cause of bile duct injury in biliary surgery. ER- CP and MRCP are the main diagnosis methods of the disease. Open cholecystectomy, bile duct repair or cholangio-jejunal Roux-en-Y anastomosis for the treatment of the patients who are definitely diagnosed before operation or highly suspected of Mirizzi syndrome are safe and feasible.