Analysis Of Diagnosis And Treatment Of Mirizzi Syndrome With Simple Gallbladder Stones Impacted

Objective: To clarify the importance of early diagnosis and treatment throughcomparing the process of diagnosis and treatment of Mirizzi syndrome with a gallbladderstones impacted in the neck. Methods: The clinical data of patients with Mirizzisyndrome and gallbladder stones impacted in the neck receiving in the first affiliatedhospital of xinjiang medical university from March2004to March2012were analyzedretrospectively. Results: In70patients,30cases for the diagnosis of Mirizzi syndrome, in30cases male14（46.7%） female16（53.3%）,The age ranged from30to86years oldaverage age was52.87,40cases for the diagnosis of gallbladder stones impacted in theneck male18（45.0%）,female22（55.0%）,The age ranged from21to74years old averageage was41.38.5cases（16.0%）in the30cases of Mirizzi syndrome were diagnosedpreoperatively.Among them1case was diagnosed by B ultrasound,1by MRCP,1byPTC,2by MRCP.25cases were diagnosed intraoperatively. Patients classified by Csendsstandard: typeI14cases,type II6cases,typeⅢ4cases,typeIV6cases,5were treated withcholecystectomy,1with partial cholecystectomy,5with cholecystectomy and T tubedrainage and abdominal drainage operations,10with cholecystectomy and repair of fistulaand T tube drainage operations,6with Roux-en-Y hepaticojejunostomy40cases ofgallbladder stones impacted in the neck were diagnosed by B ultrasound in these cases13were treated with LC,17with opencholecystectomy,10with cholecystectomy andabdominal drainage operations. In the patients with gallbladder stones impacted,3caseshad compilications including1case of fat liquefaction1case of hydrops of gallbladderfossa and1case of pulmonary infection. In the Mirizzi syndrome group9cases （30%）had compilications including2cases of bile leakage after biliary intestinal anastomosis,1 case of fat liquefaction,2cases of Incision infection,1case of pulmonary infection,1caseof acute renal failure,2cases of abdominal infection and were improved or cured in thehospital.But the onset time,length of stay,operating time,hospitalization expenses,abdominal drainage and T tube drainage time,preoperative liver function index in theMirizzi syndrome group were more high than the gallbladder stone group. there was asignificant difference（P＜0.05）.conclusion: Preoperative diagnosis of the Mirizzisyndrome is difficult comparing with simple gallbladder stones impacted,operation ismore complex,having more complications,increasing the economic burden of thepatients.So the advanced inspection means to improve the rate of preoperative diagnosis ofMirizzi syndrome,reducing the rate of bile duct injury during operation.The surgicalprocedure must be chosen according to patient’s pathological condition．...