Surgical strategies for Mirizzi syndrome:A ten-year single center experience  

作　　者：Wei Lai Jie Yang Nan Xu Jun-Hua Chen Chen Yang Hui-Hua Yao 

机构地区：[1]Department of Hepatobiliary-Pancreatic-Splenic Surgery,Chengdu First People’s Hospital(Chengdu Integrated TCM&Western Medicine Hospital),Chengdu 610044,Sichuan Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2022年第2期107-119,共13页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Mirizzi syndrome(MS)remains a challenging biliary disease,and its low rate of preoperative diagnosis should be resolved.Moreover,technological advances have not resulted in decisive improvements in the surgical treatment of MS.Complex bile duct lesions due to MS make surgery difficult,especially when the laparoscopic approach is adopted.The safety and long-term effect of MS treatment need to be guaranteed in terms of preoperative diagnosis and surgical strategy.AIM To analyze preoperative diagnostic methods and the safety,effectiveness,prognosis and related factors of surgical strategies for different types of MS.METHODS The clinical data of MS patients who received surgical treatment from January 1,2010 to December 31,2020 were retrospectively reviewed.Patients with malignancies,choledochojejunal fistula,lack of data and lost to follow-up were excluded.According to preoperative imaging examination records and documented intraoperative findings,the clinical types of MS were determined using the Csendes classification.The safety,effectiveness and long-term prognosis of surgical treatment in different types of MS,and their interactions with the clinical characteristics of patients were summarized.RESULTS Sixty-six patients with MS were included(34 males and 32 females).Magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP)showed specific imaging features of MS in 58 cases(87.9%),which was superior to ultrasound scan(USS)in the diagnosis of MS and more sensitive to subtle biliary lesions than USS.The overall laparoscopic surgery completion rate was 53.03%(35/66),where the completion rates of MS type I,II and III were 69.05%(29/42),42.86%(6/14)and zero(0/10),respectively.Thirty-one patients(46.97%)underwent laparotomy or conversion to laparotomy including 11 cases of iatrogenic bile duct injury which occurred in type I patients,and 25 of these patients underwent bile duct exploration,repair and T-tube drainage.In addition,25 patients underwent intraoperative choledochoscopy and T-

关 键 词：Mirizzi syndrome Surgical strategy Diagnosis Classification Surgical approach LAPAROSCOPE 

分 类 号：R657.4[医药卫生—外科学]