摘要
目的探讨Mirizzi综合征的病理特点及合理的诊断与治疗方法。方法对经手术证实的34例Mirizzi综合征的临床资料进行回顾性分析。结果34例(含术前明确诊断者5例)均采用手术治疗。手术方式:采用腹腔镜或开腹胆囊大部分切除7例,胆囊切除11例,胆囊切除加胆总管探查7例,用胆囊瓣瘘口修补加胆总管探查6例,肝圆韧带瘘口修补加胆总管探查1例,胆囊切除加胆肠内引流术2例。结论Mirizzi综合征术前诊断困难,术中明确诊断是防止胆道损伤的关键,治疗应根据不同的病理类型选择相应的手术方法。
Objective To discuss pathologic feature, rational diagnosis and treatment for Mirizzi syndrome. Methods The clinical data of 34 cases of Mirizzi syndrome treated by surgery were retrospectively analysed. Results Five cases were diagnosed prior to operation. All the 34 cases tmderwent operation, including laparoscopic cholecystectomy in 4 cases, laparoscopic partial cholecystecomy in 5 cases, open cholecystectomy in 7 cases, partial cholecystecomy in 2 cases, cholecystecomy plus common bile duct exploration with T tube drainage in 7 cases, closure of fistula with pedicle gallbladder flap in 6 cases and with ligamenta teres hepatis in 1 cases, choledochojejunostomy in 2 cases. Conclusion It is still difficult to diagnose Mirizzi syndrome preoperatively, and correct intraoperative diagnosis can decrease the occurrence of bile duct injuries. Appropriate operative patterns should be selected according to different types of Mirizzi syndrome.
出处
《临床医学》
CAS
2007年第3期14-15,共2页
Clinical Medicine
