Mirizzi综合征的诊治进展  

Therapeutic and diagnostic advances of Mirizzi syndrome

作　　者：付博文 阿永俊[1] Fu Bowen;A Yongjun(Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital,Kunming Medical University,Yunnan Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科,云南昆明650101

出　　处：《腹部外科》2023年第2期146-150,共5页Journal of Abdominal Surgery

摘　　要：Mirizzi综合征在临床上发病率较低,常无典型表现,导致其诊断及后续治疗困难。该病主要由多发性嵌顿性胆囊结石或Hartman囊内单个巨大嵌顿性胆结石压迫肝总管或胆总管引起,疾病的诊断主要根据磁共振胰胆管成像(MRCP)、经内镜逆行胰胆管造影(ERCP)及术中诊断等发现。近年来,随着治疗观念及医疗技术的进步,微创手术由于其创伤小、恢复快、并发症少及可分期治疗的特点,已逐渐取代传统的开腹手术成为Mirizzi综合征的主要治疗方法;另外,对于不能耐受手术的急诊病人,经皮经肝胆囊穿刺引流可作为缓解Mirizzi综合征梗阻的选择。此文就上述领域内现状及最新进展进行综述,为Mirizzi综合征的诊断及治疗提供参考。With a low incidence rate in clinical practices,Mirizzi syndrome(MS)often has non-typical manifestations so that its diagnosis and follow-up treatment remain difficult.The disease is mainly caused by multiple incarcerated gallstones or single large incarcerated gallstones in Hartman's bursa compressing common hepatic duct or common bile duct.A definite diagnosis is largely dependent upon magnetic resonance cholangiopancreatography(MRCP),endoscopic retrograde cholangiopan-creatography(ERCP)and intraoperative findings.In recent years,with the progress of treatment concept and medical technology,mini-invasive surgery has gradually replaced traditional open surgery as a major option for MS due to the advantages of minimal trauma,a rapid recovery,fewer complications and staged phases.Also for emergency patients not tolerating surgery,percutaneous hepatic puncture and gallbladder drainage may be employed for alleviating obstruction.This review summarized the current status and the latest advances in the above fields to provide reference for diagnosing and treating MS.

关 键 词：MIRIZZI综合征 临床诊断 腹腔镜下胆囊切除术 经皮经肝胆囊穿刺引流 

分 类 号：R657.4[医药卫生—外科学]