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Experience of laparoscopic diagnosis and treatment of Mirizzi syndrome in 37 cases |
LI Shu-jie GONG Zi-qi WANG Yan SUN Kai XU Cai-teng |
Department of Surgery,Changping Traditional Chinese Medicine Hospital,Beijing 102200,China |
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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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[1] |
Yip AW,Chow WC,Chan J,et al.Mirizzi syndrome with cholecystocholedochal fistula:preoperative diagnosis and management[J].Surgery,1992,111(3):335-338.
|
[2] |
Beltran MA.Mirizzi syndrome:history,current knowledge and proposal of a simplified classification[J].World J Gastroenterol,2012,18(34):4639-4650.
|
[3] |
董明杰,谈燚.腹腔镜胆囊切除术的手术类型研究进展[J].蚌埠医学院学报,2016,46(9):1256-1259.
|
[4] |
李国刚,白雪莉,梁廷波.Mirizzi综合征诊治进展[J].中国实用外科杂志,2015,35(9):1008-1010.
|
[5] |
陈芦斌,吕小慧,郭欣.腹腔镜胆囊切除术围手术期Mirizzi综合征的诊断、治疗及疗效评价[J].临床肝胆病杂志,2016,32(7):1354-1356.
|
[6] |
姚俊,周宁杰.Mirizzi综合征患者的临床病理特征及外科治疗方案的选择分析[J].当代医学,2016,22(31):39-40.
|
[8] |
朱柯磊,李定耀,蒋存兵,等.Mirizzi综合征38例临床特点分析[J].肝胆胰外科杂志,2014,26(2):156-158.
|
[10] |
奚春华,孙跃明,张川.腹腔镜胆囊切除术中Mirizzi综合征的诊治经验[J].中国现代手术学杂志,2016,20(5):335-338.
|
[11] |
牛肖雅,叶辉,陈利平,等.Mirizzi综合征47例临床特点分析[J].肝胆胰外科杂志,2016,28(6):499-501.
|
[7] |
Shenoy S.Spontaneous internal biliary fistulas from gallstones:Mirizzi′s syndrome,cholecystoenteric fistula,and gallstone ileus[J].Am Surg,2014,80(4):409-411.
|
[9] |
Sare M,Gurer S,Taskin V,et al.Mirizzi syndrome:choice of surgical procedure in the laparoscopicera[J].Surg Laparosc Endosc,1998,8(1):63-67.
|
[12] |
Chowbey PK,Sharma A,Mann V,et al.The management of Mirizzi syndrome in the laparoscopicera[J].Surg Laparosc Endosc Percutan Tech,2000,10(1):11-14.
|
[13] |
Rozsos I,Behek S,Magyarodi Z,et al.Minimally invasive surgery in the management of Mirizzi syndrome[J].Orv Hetil,1998,139(4):177-180.
|
[14] |
栗光明,朱继业,黄磊,等.Mirizzi综合征的诊治探讨[J].中国实用外科杂志,2002,22(8):494-496.
|
[15] |
孙文兵.腹腔镜时代Mirizzi综合征治疗策略新思考[J].中华肝胆外科杂志,2016,22(12):793-796.
|
|
|
|