腹腔镜治疗Mirizzi综合征36例临床分析

Clinical analysis of laparoscopic treatment for Mirizzi syndrome of 36 cases

目的探讨腹腔镜手术治疗Mirizzi综合征的经验。方法回顾分析1999年10月-2015年5月我院腹腔镜治疗Mirizzi综合征36例临床资料。结果 33例采用腹腔镜手术治疗：Ⅰ型10例行单纯胆囊切除术,Ⅱ型23例中3例行单纯胆囊切除术,12例行胆囊大部切除术加胆管瘘修补术,8例行胆囊大部切除术加胆管瘘修补＂T＂型管引流术。Ⅲ型和Ⅳ型3例为中转开腹手术。随访6-60个月,无胆道狭窄和结石残留等并发症。结论腹腔镜手术治疗Mirizzi综合征Ⅰ型、Ⅱ型在技术上切实可行,适宜于腹腔镜技术较成熟的医院开展。

Objective To summarize the experience of laparoscopic treatment of Mirizzi syndrome.Methods The clinical data of 36 patients with laparoscopic treatment of Mirizzi syndrome from October 1999 to May 2015.Results 33 cases of laparoscopic surgery：Type Ⅰ 10 cases underwent with simple cholecystectomy,3 cases in type Ⅱ 23 cases underwent simple cholecystectomy,12 patients underwent resection of the gallbladder most bile duct fistula repair;8 patients underwent resection of the gallbladder majority and bile duct fistula repair type ＂T＂ tube drainage.3 cases of typeⅢ and type Ⅳ for the transfer to laparotomy.Followed up for 6 to 60 months after operation,there were no bile duct stenosis and residual stones and other complications.Conclusion Laparoscopic treatment of Mirizzi syndrome typeⅠ and type Ⅱ is technically feasible,and appropriate to be carried out in sophisticated unit.