First Surgical Department, Papageorgiou General Hospital, Thessaloniki, Greece.
Surg Endosc. 2010 Jan;24(1):33-9. doi: 10.1007/s00464-009-0520-5. Epub 2009 May 23.
This article reviews the feasibility of the laparoscopic treatment of Mirizzi syndrome and determines the associated risks and complications of this technique.
An electronic search of the literature between 1989 and 2008 was undertaken to identify relevant articles. Studies comprising at least four patients treated by laparoscopy and reporting on the preoperative diagnosis rate and analytical conversion and complication data were considered for inclusion.
From 66 abstracts reviewed, 10 eligible studies were identified. Conversion, complication, and reoperation rates were 41%, 20%, and 6%, respectively. The risks for open conversion and procedure-related complications were similar for patients with type I and type II Mirizzi syndrome. However, patients of studies reporting a high preoperative diagnosis rate had a significantly lower risk for conversion (p < 0.05), procedure-related complications (p < 0.05), and reoperation (p < 0.05), when compared with studies with a low preoperative diagnosis rate.
Current evidence suggests that laparoscopic treatment of Mirizzi syndrome cannot be recommended as a standard procedure. Preoperative diagnosis of the syndrome seems an important predicting factor of technical success.
本文综述了腹腔镜治疗 Mirizzi 综合征的可行性，并确定了该技术相关的风险和并发症。
对 1989 年至 2008 年间的文献进行电子检索，以确定相关文章。纳入标准为至少有 4 例患者接受腹腔镜治疗，并报告术前诊断率、中转开腹率及并发症数据的研究。
从 66 篇摘要中，我们共识别出 10 项符合条件的研究。中转开腹率、并发症发生率和再次手术率分别为 41%、20%和 6%。对于Ⅰ型和Ⅱ型 Mirizzi 综合征患者，中转开腹和与手术相关的并发症的风险相似。然而，与术前诊断率低的研究相比，术前诊断率高的研究中转开腹（p < 0.05）、与手术相关的并发症（p < 0.05）和再次手术（p < 0.05）的风险显著降低。
目前的证据表明，腹腔镜治疗 Mirizzi 综合征不能作为标准治疗方法。术前对该综合征的诊断似乎是技术成功的一个重要预测因素。
