Mirizzi综合征18例外科治疗体会

Experience in diagnosis and treatment of 18 cases of Mirizzi syndrome

目的 :提高临床上对Mirizzi综合征的认识 ,避免胆道损伤。方法 :对经手术证实的 18例Mirizzi综合征的临床资料进行回顾性分析。结果 :术前明确诊断者仅 3例。行单纯胆囊切除 11例 ,胆囊切除、胆管壁瘘口修补 3例 ,胆囊切除、瘘口修补、T型管引流 3例 ,胆囊切除、肝总管空肠Roux -en-y吻合术 1例。随访 11例平均时间 5年 ,无胆道狭窄情况。结论 :为避免胆道损伤 ,应结合病史、体检、化验及影像学检查进行全面综合分析 ,以提高术前确诊率 ,在手术时要认真对待 。

Objective:To improve the understanding of Mirizzi syndrome in clinical medicine and avoid causing damage to biliary passage. Methods: Review and analyze the clinical data of 18 cases of Mirizzi syndrome, which have been confirmed by operation.Results: Only 3 cases are clearly diagnosed before operation. We have performed 11 cases of mere removal of gallbladder. We have carried out 3 cases of fistula wall repair and simultaneously removal of gallbladder is performed. We have done 3 cases of T-duct drainage and at the same time removal and some repair work are carried out and done 1 case of Roux-en-y anastomosis of common bile duct and jejunum besides removal of gallbladder. Follow-up to 11 cases for a mean of 5 years in showed no bile duct straitness. Conclusions: In order to avoid causing damage to biliary passage and increase diagnosing rate before operation, we should carry out a comprehensive analysis according to case history, physical examination, laboratory test and iconography examination. When carry out an operation, we should be strict and careful to choose the proper form of operation according to what has happened and is happening during the operation.