Abstract：Objective To explore the diagnosis of Mirizzi syndrome and the treatment by laparoscopic surgery.Methods The clinical data of Mirizzi syndrome patients who were diagnosed before or during the surgery from January 2002 to December 2016 in our hospital were retrospectively analyzed.Results A total of 37 patients with Mirizzi syndrome were enrolled including typeⅠ(n=28),typeⅡ(n=8),and typeⅢ(n=1).No typeⅣcase was involved in this study.Among typeⅠ,18 patients were performed with laparoscopic cholecystectomy,7 with laparoscopic sub-total cholecystectomy,and the rest 3 patients were converted to laparotomy due to severe adhesion or biliary injury.Among typeⅡ,5 patients were performed with laparoscopic sub-total cholecystectomy+fistula repair,1 with the combination of laparoscopic choledocholithotomy+sub-total cholecystectomy+fistula repair+T tube drainage(T tube across the fistula site),and the remaining 2 were converted to laparotomy due to common hepatic duct injury.Among typeⅢ,the patient was converted to cholecystojejunostomy (Roux-en-Y)by laparotomy due to large common hepatic duct fistula.Conclusion For patients with suspected Mirizzi syndrome,preoperative examination should be performed to confirm the diagnosis.Laparoscopic surgery is safe and feasible for typeⅠ and partial typeⅡ patients,but for patients with typeⅡin severe local adhesion or large fistula,Ⅲand Ⅳ,laparotomy is an optimal choice.
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