【摘要】 目的:探讨Mirizzi综合征的诊断及减少术中医源性胆管损伤的处理措施。方法:回顾分析我院31例Mirizzi综合征患者诊断、分型、手术方法等临床资料,并与同期3185例非Mirizzi综合征患者行胆囊切除术时医源性胆管损伤发生率进行比较。结果:31例Mirizzi综合征术前确诊9例,术中损伤胆管8例;3185例非Mirizzi综合征胆囊切除术中损伤胆管4例。结论:Mirizzi综合征已成为胆道外科手术中致胆管损伤的主要因素;ERCP、MRCP是诊断该病的主要检查方法;对术前确诊及高度怀疑此病的患者,主张开腹行胆囊切除、胆管修补或胆肠Roux-en-Y吻合术,这样会带来更多的安全性及获得正确的处理办法。更多还原

【Abstract】 Objective:To explore the diagnosis and treatment of Mirizzi syndrome and the intraoperative management of reducing iatrogenic bile duct injuries.Methods:The clinical data of 31 patients with Mirizzi syndrome were analyzed retrospectively on diagnosis,clinical type and surgery method,compared with the incidence rate of iatrogenic bile duct injuries in 3 185 patients undergoing cholecystectomy without Mirizzi syndrome.Results:Mirizzi syndrome was definitely diagnosed before operation in 9 of the 31 patients and 8 patients suffered intraoperative bile duct injuries.However,intraoperative bile duct injuries only occurred in 4 of the 3 185 patients without Mirizzi syndrome who underwent cholecystectomy.Conclusions:Mirizzi syndrome becomes main cause of bile duct injury in biliary surgery.ERCP and MRCP are main diagnosis methods of the disease.For those who are definitely diagnosed before operation or highly suspected of Mirizzi syndrome,safe and effective surgical management includes open cholecystectomy,bile duct repair and cholangio-jejunal anastomosis of Roux-en-Y.更多还原