Mirizzi综合征腹腔镜手术治疗临床分析

Clinical analysis of laparoscopic surgery for Mirizzi syndrome

目的:探讨临床腹腔镜手术治疗Mirizzi综合征的疗效。方法:收治腹腔镜手术证实Mirizzi综合征患者60例。其中术前确诊28例(术前组),术中确诊32例(术中组),比较两组手术疗效。结果:确诊为Mirizzi综合征Ⅰ、Ⅱ、Ⅲ、Ⅳ型各有34例、22例、2例和2例。腹腔镜手术患者55例,其中,中转开腹6例,胆囊切除术34例,胆囊大部切除术21例。Ⅱ型患者Ⅰ期缝合修复瘘口13例,胆囊组织覆盖修复瘘口8例。术后并发症8例,后期均痊愈。术前组和术中组患者并发症发生率分别为7.69%和21.70%(P<0.05)。术后无并发症发生。结论:腹腔镜手术治疗Mirizzi综合征Ⅰ、Ⅱ型安全、可行,并发症少,术前确诊可减少手术并发症,提高疗效。

Objective：To explore the clinical effect of laparoscopic surgery for Mirizzi syndrome.Methods：60 patients with Mirizzi syndrome confirmed by laparoscopic surgery were admitted,among them,28 cases were diagnosed before operation（the preoperative group） and 32 cases were diagnosed after operation（the intraoperative group）,we compared the smgical outcomes between the two groups.Results：There were 34 eases of type ⅠI ,22 eases of type Ⅱ ,2 eases of type Ⅲ and 2 eases of type Ⅳ of Mirizzi syndrome.55 patients underwent laparoseopie surgery,among them,5 eases were converted to laparotomy,34 eases underwent eholeeysteetomy,and 21 eases underwent subtotal eholeeysteetomy.In type Ⅱ patients,13 eases were treated with one-stage suture to repair fistula,8 eases were treated with gallbladder tissue covering the fistula.Postoperative complications occurred in 8 eases,and 8 eases were all recovered in the later stage.In the preoperative group and the intraoperative group,the incidence of complications was 7.69% and 21.70% respectively（P 〈 0.05）.There was no complications after operation.Conclusion： Laparoseopie surgery was safe and feasible in the treatment of Mirizzi syndrome of type I and Ⅱ ,complications were few, preoperative diagnosis can reduce operative complications and improve curative effect.