腹腔镜胆囊切除术中Mirizzi综合征的诊治探讨  

Diagnosis and Treatment of Mirizzi Syndrome During Laparoscopic Cholecystectomy

作　　者：刘乙静 郑玉高 LIU Yijing;ZHENG Yugao(The Second Department of Surgery,The Fifth People's Hospital of Yichang City,Yichang Hubei 443007,China)

机构地区：[1]湖北省宜昌市第五人民医院外二科,湖北宜昌443007

出　　处：《中国继续医学教育》2019年第12期86-88,共3页China Continuing Medical Education

摘　　要：目的探讨腹腔镜胆囊切除术中Mirizzi综合征患者人群分布特点、发病原因分析以及诊治心得体会。方法选择2017年6月—2018年6月在本院行腹腔镜胆囊切除术的35例患者作为研究对象。其中城镇居民19例作为对照组,农村居民16例作为观察组。两组患者均行腹腔镜胆囊切除术,术后收集两组患者临床资料,统计术中Mirizzi综合征发生率及胆总管损伤情况,对比两组发生率,同时观察Mirizzi综合征患者临床特征。结果观察组Mirizzi综合征发生率(18.75%)与术中胆总管损伤发生率(18.75%)均高于对照组(5.26%、0.00%),差异具有统计学意义(P <0.05)。结论农村患者腹腔镜胆囊切除术中检出Mirizzi综合征概率明显高于城镇患者,人群分布具有一定规律性,临床治疗中应注意避免胆总管损伤,并选择合理的胆道损伤后手术处理方式。Objective To investigate the distribution characteristics, pathogenesis and diagnosis and treatment of patients with Mirizzi syndrome during laparoscopic cholecystectomy.Methods A total of 35 patients who underwent laparoscopic cholecystectomy in our hospital from June 2017 to June 2018 were selected as the study subjects.19 urban residents served as control group.16 rural residents served as observation group.Laparoscopic cholecystectomy was performed in both groups.The clinical data of two groups were collected after operation,and the incidence of Mirizzi syndrome and common bile duct injury during operation were counted.The incidence of Mirizzi syndrome was compared between the two groups,and the clinical characteristics of Mirizzi syndrome were observed.Results The incidence of Mirizzi syndrome (18.75%) and intraoperative common bile duct injury (18.75%) in the observation group were higher than those in the control group (5.26% and 0.00%).The difference was statistically significant (P<0.05).Conclusion The probability of detecting Mirizzi syndrome in laparoscopic cholecystectomy in rural areas is significantly higher than that in urban patients.The population distribution has certain regularity.In clinical treatment,attention should be paid to avoid common bile duct injury,and reasonable surgical treatment after biliary injury should be selected.

关 键 词：MIRIZZI综合征 腹腔镜 胆囊切除术 诊治心得 胆总管损伤 并发症 

分 类 号：R657[医药卫生—外科学]