Kawaguchi Tsutomu, Itoh Tadao, Yoshii Kazuhiro, Otsuji Eigo
Surgery and Gastroenterological Center, Rakuwakai Marutamachi Hospital, Kyoto, Japan ; Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Surg Case Rep. 2015;1(1):51. doi: 10.1186/s40792-015-0052-2. Epub 2015 Jun 17.
Gallstone obstruction of the cystic duct, resulting in chronic cholecystitis and pressure necrosis leads to the formation of biliobiliary fistula (BBF). We herein reported a case of Mirizzi syndrome (MS) with an unusual type of BBF (Corlette type I) that was successfully managed by a staged treatment strategy. The patient was diagnosed with a solitary gallstone, marked atrophy of the gallbladder, and BBF and underwent mucosal incineration of the atrophic gallbladder and simple closure, followed by extirpation of gallbladder. Although an optimal treatment strategy has not yet been established for MS with BBF because of its rarity and anatomical variations in fistulas, the current treatment strategy may be applicable. In conclusion, clinicians need to carefully diagnose and evaluate chronic cholecystitis in MS with BBF and adopt an optimal treatment strategy to avoid the complication associated with this disease.
胆囊管结石梗阻,导致慢性胆囊炎和压迫性坏死,进而形成胆胆瘘(BBF)。我们在此报告一例Mirizzi综合征(MS)合并一种不寻常类型的BBF(Corlette I型),该病例通过分期治疗策略成功治愈。患者被诊断为单发胆囊结石、胆囊明显萎缩和BBF,接受了萎缩胆囊的黏膜烧灼和单纯缝合,随后进行胆囊切除。由于MS合并BBF较为罕见且瘘管存在解剖变异,目前尚未确立最佳治疗策略,但当前的治疗策略可能适用。总之,临床医生需要仔细诊断和评估MS合并BBF的慢性胆囊炎,并采用最佳治疗策略以避免与该疾病相关的并发症。