Mirizzi综合征的腹腔镜治疗对策及胆管损伤的预防  

Treatment of Mirizzi syndrome with laparoscope and prevention of bile duct injury in the operation

作　　者：莫晓东[1] 吴国忠[1] 

机构地区：[1]解放军第101医院普通外科,江苏无锡214044

出　　处：《局解手术学杂志》2007年第6期396-397,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨腹腔镜手术治疗Mirizzi综合征的对策和预防胆管损伤的关键方法。方法回顾性分析我院1996年至2006年行腹腔镜胆囊切除术(LC)59例Mirizzi综合征的临床资料。结果成功完成腹腔镜手术(laparoscope,LC)35例,Ⅰ型31例,Ⅱ型4例。未完成LC 24例,其中发生肝胆管损伤8例(Ⅰ型6例,Ⅱ型2例),随访2年,预后良好。结论腹腔镜手术治疗MSI型、部分Ⅱ型是可行的、安全的,治疗成功的关键在于Mirizzi综合征的术中确诊和分型的判断。避免胆管损伤的关键是术中正确辨认出肝总管。Objective To explore the strategy of treating Mirizzi syndrome（MS） with laparoscope and prevention of bile duct injury in the operation. Methods Clinical data of 59 MS cases was retrospectively analyzed. Results Totally 35 cases were successfully treated with laparoscope, among which, 31 cases were type Ⅰ, and 4 cases type Ⅱ; 24 cases failed laparoscope cholecystectomy, with 8 cases of hepatobiliary duct injury （6 cases of type Ⅰ, 2 cases of type Ⅱ）. It showed good prognosis in two years of follow-up. Conclusion Laparoscope cholecystectomy is a feasible and safe choice for MS type Ⅰ patients and some type Ⅰ patients. The key point lies in the confirming diagnosis of Mirizzi syndrome and MS typing in the operation course, while the critical point for avoiding bile duct injury lying in the accurate recognition of hepatic common duct.

关 键 词：MIRIZZI综合征 腹腔镜 胆囊切除术 胆管损伤 

分 类 号：R575.7[医药卫生—消化系统] R657.43[医药卫生—内科学]