Mirizzi综合征与胆囊癌的关联性探讨  

Coincidence of Mirizzi Syndrome and Gallbladder Carcinoma

作　　者：宋念[1] 杨汉新[1] 刘金玉[1] 

机构地区：[1]成都市第一人民医院,四川成都610016

出　　处：《成都医药》2003年第6期349-350,共2页

摘　　要：目的 :探讨Mirizzi综合征和胆囊癌的关联性。方法 :回顾性研究了 4 32 0例胆囊切除病例的一般临床资料、实验室数据、诊断资料、病理报告和术中发现。仅有 34例证实为Mirizzi综合征的病人被纳入本组资料进行分析。结果 :1993～ 2 0 0 2年 4 32 0例胆囊切除中有 34例 (0 8% )为Mi rizzi综合征 ,这些病人中有 10例 (2 9 4 % )符合胆囊癌 ,4 32 0例胆囊疾患病人中 4 8例 (1 1% )作出胆囊癌诊断 ,与Mirizziz综合征的发生率 (2 9 4 % ,10 / 34)比较有明显差异。Mirizzi综合征的患者中 2 8例伴有肿瘤抗原CA19- 9水平升高 ,而其中 10例胆囊癌患者明显升高 (P <0 0 1)。结论 :对Mirizzi患者应作术中冰冻切片 ,做出可靠诊断以避免二次手术。Objective:To investigate the coincidence of gallbladder carcinoma associated with Mirizzi syndrome.Method:patient demographics,clinical findings,laboratory data,result of diagnostic studies,pahthologic reports and intraoperative findings of 4 320 patient underwent cholecystectomy were obtained from patient records and were restrospectively studied.Only 34 patients with proven Mirizzi syndrome were included in this study. Results:34(0 8%) cases of Mirizzi syndrome out of 4 320 cholecystectomies perform between 1993 and 2002 were identified.In theses patients 10 coincidental cases(29 4%)of a gallbladder carcinoma were detected. The incidence of unsuspected malignancies in gallstone disease was48(1 1%)of 4 320 and was statistically different from the incidence in patients with Mirizzi syndrome(29 4%,10 of 34)Tumor-associated antigenCA 19-9 level was elevated in 28 patients with Mirizzi syndrome,but it was significantly higher ( P <0 01) in all ten patients with coincidental gallbladder neoplasm.Conclusion:Because of this high coincidence of Mirizzi syndrome and gallbladder cancer,we recommend an frozen section of the gallbladder wall in presence of Mirizzi syndrome to prevent a second procedure.

关 键 词：MIRIZZI综合征 胆囊癌 胆囊切除 梗阻性黄疸 胆管炎 胆囊结石 并发症 

分 类 号：R735.8[医药卫生—肿瘤] R575[医药卫生—临床医学]