摘要
目的 探讨 Mirizzi综合征的诊断和治疗。方法 对 4 3例 Mirizzi综合征的临床资料进行回顾性研究。结果 Mirizzi综合征占同期慢性结石性胆囊炎手术病例的 1.87% ,2 0 .9% ( 9/ 4 3 )的病例经术前 B超、PTC、ERCP确诊 ,术中确诊79.1% ( 3 4 / 4 3 )。术中发现胆囊颈或胆囊管有结石嵌顿者占 83 .7% ( 3 6/ 4 3 ) , 型 2 8例、 型 11例、 型 3例、 型 2例 ,全部病例经手术治疗愈 ,其中胆囊切除或部分切除 2 8例、胆囊瓣补片加 T型管引流 4例、肝圆韧带补片 T型管引流 1例、胆道瘘口楔形切除胆道吻合修补 3例、肝总管空肠 Roux- en- y吻合术 3例。随访 2～ 7年 ,健康。结论 Mirizzi综合征是慢性结石性胆囊炎的并发症 ,B超能为诊断提供线索 ,PTC、ERCP是术前具确诊价值的检查 ;手术是确诊的另一手段。 Mirizzi综合征手术治疗原则为切除胆囊、解除梗阻、防止胆道损伤、修复胆道、通畅引流胆汁。根据不同的类型分别选择胆囊切除或部分切除、各类胆道修补 T型管引流、胆肠 Roux- en- y吻合术。 Mirizzi综合征手术治疗效果良好。
Objective To discuss the diagnosis and treatment of Mirizzi syndrome.Methods A retrospective study was taken on 43 cases with Mirizzi syndrome.Results Mirizzi syndrome accounts for 1.87% of all operation cases with chronic cholecystonlithiasis in the same period.9 cases (20.9%) were confirmed by B-supersonic examination?PTC and ERCP before operation,34 cases (79.1%) were confirmed in operation.36 cases (83.7%) with stone incarceration in gallbladder neck or cystic duct,Ⅰ type 28 cases,Ⅱ type 11 cases,Ⅲ type 3 cases,Ⅳ type 2 cases.All patients were cured by operations,cholecystectomy of partial cholecystectomy performed for 28 cases,repairing with gallbladder wall and T-tube drainage for 4 cases,repairing with round ligament of liver and T-tube drainage for 1 cases,fistula orifice wedge resecting and repairing for 3 cases.Roux-en-y hepatio-jejunostomy for 3 cases.All patients were followed up from 2 to 7 years with health.Conclusion Mirizzi syndrome is the complication of chronic cholecystonlithiasis.B-supersonic examination can provide diagnosis clues.Diagnosis can be confirmed by PTC or ERCP before operation,operation is a comfirming means too.Operation principle are to resect gallbladder,deliver obstruction,prevent bile duct injury,repair bile duct for smooth bile drainage.Operations are selected according to the types of Mirizzi syndrome.Operation is good to Mirizzi syndrome.
出处
《肝胆外科杂志》
2001年第4期284-286,共3页
Journal of Hepatobiliary Surgery
