全麻仰卧位下同步双镜联合在Ⅰ型Mirizzi综合征并胆总管结石手术中的应用价值  

Laparoscopic and endoscopic cooperative surgery with supine position under general anesthesia in the operation of type Ⅰ Mirizzi syndrome with choledocholithiasis

作　　者：郭志唐 魏东[1] 李伟思 许宁[1] 陈章彬 滕毅山[1] 孙敏[1] 施智甜 叶正陈 赵瑜[1] 李文[1] 王琳[1] 戈佳云[1] Guo Zhitang;Wei Dong;Li Weisi;Xu Ning;Chen Zhangbin;Teng Yishang;Sun Min;Shi Zhitian;Ye Zhengchen;Zhao Yu;Li Wen;Wang Lin;Ge Jiayun(Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101 Xhina)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科,650101

出　　处：《中华普通外科杂志》2020年第9期681-684,共4页Chinese Journal of General Surgery

基　　金：国家自然科学基金(81660399)。

摘　　要：目的探讨全麻仰卧位下同步双镜联合在Ⅰ型Mirizzi综合征并胆总管结石手术治疗中的应用价值。方法回顾性分析昆明医科大学第二附属医院2018年1月至2020年1月收治的53例采用全麻仰卧位下同步双镜联合(preLC+ERCP+EST)治疗的I型Mirizzi综合征合并胆总管结石患者的临床病例资料。结果53例患者均顺利完成LC手术,2例患者ERCP+EST失败,成功率96.2%。1例患者术后并发出血坏死性胰腺炎及胰腺假性囊肿,2例患者并发慢性胰腺炎,3例患者术后常感上腹不适,复查MRCP提示胆囊管残株炎,其余病例随访至今未见异常。结论全麻仰卧位下同步双镜联合技术治疗Ⅰ型Mirizzi综合征合并胆总管结石是微创、有效的。Objective To explore the value of laparoscopic and endoscopic cooperative surgery with the patient lying on supine position under general anesthesia in the operation of type Ⅰ Mirizzi syndrome with choledocholithiasis.Methods From Jan 2018 to Jan 2020,53 cases of Mirizzi syndrome with choledocholithiasis undergoing laparoscopic and endoscopic cooperative surgery(preLC+ERCP+EST)at the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed.Results 53 patients successfully underwent LC without conversion to open surgery,and 2 patients failed in ERCP+EST attempt,with a success rate of 96.2%.One patient developed pancreas pseudocyst as a result of postoperative hemorrhagic necrotizing pancreatitis.Two patients suffered from chronic pancreatitis.Three patients complaining postoperative upper abdominal discomfort were finally diagnosed as stump cystic duct inflammation by MRCP,and no abnormalities were found in the follow-up of the remaining cases.Conclusion Laparoscopic and endoscopic cooperative surgery in the treatment of patients with type Ⅰ Mirizzi syndrome combined with choledocholithiasis is minimally invasive and effective.

关 键 词：MIRIZZI综合征 内窥镜 腹腔镜 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]