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腹腔镜胆囊切除术时Mirrizzi综合征的处理
作者:董云生 佟强 赵刚 
单位:南京市浦口医院
关键词:Mirrizzi综合征 LC 胆囊切除术 胆管修补术 胆肠吻合术。 
分类号:
出版年·卷·期(页码):2013·41·第二期(126-128)
摘要:

目的:探讨腹腔镜胆囊切除术时Mirrizzi综合征的处理。方法:腹腔镜胆囊切除术诊断Mirrizzi综合征患者12例,术前明确诊断者4例,其余均在术中发现。对于Sherry I型患者采用腹腔镜胆囊切除术,II型患者采用胆囊切除胆管修补术和胆肠吻合术,术中全部采用刮吸解剖技术分离处理胆囊三角。结果:Sherry分型I型8例采用胆囊切除术。II型4例2例胆管修补成型术2例胆肠吻合术。全部病例手术顺利,术后恢复良好,无严重并发症。结论:Mirrizzi综合多在LC术中发现,术中应根据不同类型选择不同的术式。应用刮吸解剖技术分离处理胆囊三角可提高本病的发现并减低胆管损伤。关键词:Mirrizzi综合征;LC;胆囊切除术;胆管修补术;胆肠吻合术。

Objective:Study of Mirrizzi syndrome in laparoscopic cholecystectomy. Method:Laparoscopic cholecystectomy in patients with diagnosis of Mirrizzi syndrome in 12 cases, 4 cases are prospected to have Mirrizzi syndrome preoperatively and the rest were found in LC. Patients who scored Sherry type I underwent laparoscopic cholecystectomy while type II with gallbladder excision plus repair of bile duct or R-Y entrerobiliary anastomosis. By means of curettage and aspiration technique in separation of Calot triangle is recommended. Results:8 cases of Sherry I underwent cholecystectomy. In Type II, 2 of 4 cases received bile duct repair procedure and other 2 with enterobiliary anastomosis. All cases recovered well and have no severe complications after the operations. Conclusion:Mirrizzi syndrome are often encountered during LC. Operative methods are associated with different classification. Application of curettage and aspiration technique in separating Calot triangle can enhance the identifying of the disease and educe bile duct injury. Keyword:Mirrizzi syndrome; LC;Cholecystectomy;Repair of Bile Duct; Enterobiliary Anastomosis.

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