Mirizzi综合征12例临床分析  

Analysis of 12 Cases of Mirizzi Syndrome

作　　者：朱黎庆[1] 蒋一鸣[1] 华蕾[1] 韩峰[1] 

机构地区：[1]上海市普陀区中心医院外科,上海200062

出　　处：《苏州医学院学报》2000年第6期560-561,共2页Acta Academiae Medicinae Suzhou

摘　　要：目的　通过术中 12例Mirizzi综合征的确认 ,提高术前和术中对该征的认识。方法　分析 12例Mirizzi综合征的临床特点 ,均表现为单纯胆囊结石伴间歇性黄疸、胆管炎反复发作。术前确诊 2例 ,术中确诊 10例。根据术中所见 ,按Csendes分型 ,Ⅰ型 9例 ,Ⅱ型 2例 ,Ⅲ型 1例。急诊手术 8例 ,择期手术 4例。其中行单纯胆囊切除 5例 ,加作胆总管切开T管引流 5例 ,胆管空肠Roux -en -Y吻合术 2例。结果　除加作T管引流者中有 1例术后发生胆总管狭窄外 ,余术后均恢复顺利 ,无并发症。结论　该综合征术前诊断有一定困难 ,但病史特点和影像学检查及Csendes分型对诊断、治疗有指导意义。Objective To improve diagnosis of Mirizzi syndrome before and in operation,through analysis of 12 cases of Mirizzi syndrome diagnosed in operation.Methods Twelve cases of patients with Mirizzi syndrome were characterized by calculus in the gallbladder accompanied by intermittent jaundice or frequently episodes of cholangitis,which were confirmed by examination of ultrasonography、CT、ERCP,and the findings in operations.by the Csendes classification,9 cases in the category of type Ⅰ,3 type Ⅱ and 1 case type Ⅲ.The methods of operation were cholecystectomy 5 cases、exploration of the common bile duct with T tube (5 cases),cholangioje junostomy Roux-en-Y (2 cases).Eight patients were operated immediately.Results Eleven cases of all were cured without any complication.There was 1 cases with stenosis of the common bile duct.Conclusion It is difficult to diagnose Mirizzi syndrome before operations.Clinial characteristics and the combination of several imaging modalities are preferable.And Csendes classification are beneficial for surgical therapy.

关 键 词：MIRIZZI综合征 诊断 治疗 病因 

分 类 号：R657.4[医药卫生—外科学]