Payá-Llorente Carmen, Vázquez-Tarragón Antonio, Alberola-Soler Antonio, Martínez-Pérez Aleix, Martínez-López Elías, Santarrufina-Martínez Sandra, Ortiz-Tarín Inmaculada, Armañanzas-Villena Ernesto
Department of Surgery, Hospital Doctor Peset, Valencia, Spain.
Ann Hepatobiliary Pancreat Surg. 2017 May;21(2):67-75. doi: 10.14701/ahbps.2017.21.2.67. Epub 2017 May 23.
BACKGROUNDS/AIMS: Mirizzi syndrome (MS) is an uncommon complication of cholelithiasis. The aim of this study is to evaluate our 15-year experience in this challenging entity and to propose a new classification for this disease.
A retrospective study including patients diagnosed with Mirizzi syndrome and undergoing surgical procedures for Mirizzi syndrome between January 2000 and October 2015 was conducted. Data collected included clinical, surgical procedure, postoperative morbidity. Patients were evaluated according to the Csendes classification and the proposed system, in which patients were divided into three types and three subtypes.
28 patients were included for analysis. They accounted as the 0.5% of a total of 4853 cholecystectomies performed in the study period. There were 21 women and 7 men. Initial laparotomic approach was performed in 12 patients and in 16 patients laparoscopic procedures were attempted. The procedure was completed in only 6 patients, 5 presenting type I and 1 type II Mirizzi syndrome. Mean postoperative stay was 15±9 days. Postoperative morbidity rate was 28%. Postoperative mortality was none.
Laparoscopic surgery for Mirizzi syndrome has been shown succesful only in early stages. A novel classification is proposed, based on the types of common bile duct injuries and in the presence cholecystoenteric fistula.
背景/目的：Mirizzi综合征（MS）是胆石症一种罕见的并发症。本研究的目的是评估我们在这个具有挑战性的病症上15年的经验，并为该疾病提出一种新的分类方法。
进行一项回顾性研究，纳入2000年1月至2015年10月期间诊断为Mirizzi综合征并接受Mirizzi综合征手术治疗的患者。收集的数据包括临床、手术过程、术后发病率。根据Csendes分类法和提议的系统对患者进行评估，其中患者被分为三种类型和三个亚型。
28例患者纳入分析。他们占研究期间共4853例胆囊切除术的0.5%。有21名女性和7名男性。12例患者采用初始开腹手术，16例患者尝试腹腔镜手术。仅6例患者完成手术，5例为I型Mirizzi综合征，1例为II型Mirizzi综合征。术后平均住院时间为15±9天。术后发病率为28%。无术后死亡病例。
Mirizzi综合征的腹腔镜手术仅在早期阶段显示成功。基于胆总管损伤类型和存在胆囊肠瘘的情况提出了一种新的分类方法。
