| Objective:To summarize the experience in diagnosis and treatment of Mirizzi syndrome(MD).Methods:38cases of MD proved by operation were retrospectively analyzed and followed-up. The clinical manifestations, diagnosis and treatment process of all38cases were comprehensively analysed.Results:Therapeutic method:the diagnosis was made before operation in16cases (preoperative diagnosed group).22cases were diagnosed in operation (preoperative undiagnosed group). Nine cases were diagnosed by ERCP, seven cases diagnosed by comprehensive analysis of clinical data. Patients classified by Csendes standard:type Ⅰ20cases, type Ⅱ14cases, type Ⅲ3cases, type IV1cases. Of the38cases,12were treated with cholecystectomy;8with partial cholecystectomy;2with cholecystectomy and repair of fistula;15with cholecystectomy and repair of fistula and T tube drainage operations;1with Roux-en-Y hepaticojejunostomy.Treatment results:The post-operation course was uneventful, except for one case of incision infection. Postoperative hospital stay:7-25d (average11.4d). Pathology:10cases were chronic cholecystitis with stones,15cases were acute exacerbation of chronic cholecystitis with stones,7cases were acute suppurative cholecystitis with stones,3cases were acute gangrenous cholecystitis with stones,3cases were Xanthogranulomatous cholecystitis with stones. All patient were followed up for six months-2years, no biliary stricture and stone recurrence and other complications.Conclusion:MD is difficult to diagnose before operation. Accurate preoperative diagnosis can prevent bile duct injury. |
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