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首页> 外文期刊>Surgical Endoscopy >Laparoscopic treatment for Mirizzi syndrome.
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Laparoscopic treatment for Mirizzi syndrome.

机译：腹腔镜治疗Mirizzi综合征。

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Background: Mirizzi syndrome is an uncommon complication of longstanding gallstone disease resulting in obstructive jaundice and remains surgically challenging. Mirizzi syndrome is generally considered a contraindication to laparoscopic surgery. We present the surgical experience of 11 consecutive patients with Mirizzi syndrome who were diagnosed correctly preoperatively and treated laparoscopically. Methods: From January 1991 to December 2001, 4,560 patients underwent laparoscopic cholecystectomy for gallbladder lesions, 11 (0.24%) of whom were diagnosed with Mirizzi syndrome. Results: The 11 patients diagnosed with Mirizzi syndrome included four men and seven women, with ages ranging from 21 to 72 years (median, 54). There were 10 patients with Mirizzi syndrome type I (one was caused by gallbladder cancer in the neck), and 1 patient with type II, according to McSherry's classification. Right upper quadrant abdominal pain was the most common symptom, occurring in all 11 patients. All 11 patients were diagnosed correctly preoperatively by endoscopic retrograde cholangiography (ERCP) with 100% sensitivity. Four of the 11 patients (36.4%) were converted to open procedure. The postoperative course was uneventful, except for one patient complicated with a residual common bile duct stone. Hospital stay ranged from 4 to 33 days (median, 7). Conclusions: Mirizzi syndrome is an uncommon disorder. Preoperative suspicion is crucial for correct preoperative diagnosis. ERCP is the most useful tool for correct preoperative diagnosis and consequent prevention of common bile duct injury during operation. Should Mirizzi syndrome be diagnosed, laparoscopic treatment is a feasible and safe procedure, especially for type I Mirizzi syndrome.
机译：背景：Mirizzi综合征是长期胆结石疾病的罕见并发症，可导致阻塞性黄疸，但仍具有手术挑战性。 Mirizzi综合征通常被认为是腹腔镜手术的禁忌症。我们介绍了连续11例Mirizzi综合征患者的手术经验，这些患者在术前被正确诊断并接受腹腔镜治疗。方法：从1991年1月至2001年12月，对4,560例因胆囊病变行腹腔镜胆囊切除术的患者进行了诊断，其中11例（0.24％）被诊断为Mirizzi综合征。结果：11例确诊为Mirizzi综合征的患者包括4名男性和7名女性，年龄范围为21至72岁（中位数为54岁）。根据McSherry的分类，有10例Mirizzi综合征I型患者（其中1例由颈部胆囊癌引起），而1例II型患者。右上腹腹痛是最常见的症状，发生在所有11例患者中。所有11例患者在术前均经内镜逆行胆管造影术（ERCP）正确诊断，敏感性为100％。 11名患者中有4名（36.4％）转为开放手术。术后过程平稳，除了一名患者并留有残留的胆总管结石。住院时间从4到33天不等（中位数为7）。结论：Mirizzi综合征是一种罕见的疾病。术前怀疑对于正确的术前诊断至关重要。 ERCP是正确的术前诊断并因此预防术中胆总管损伤的最有用工具。如果诊断出Mirizzi综合征，则腹腔镜治疗是一种可行且安全的方法，尤其是对于I型Mirizzi综合征。

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