Salgado-Garza Gustavo, Hernandez-Arriaga Pamela, Gonzalez-Urquijo Mauricio, Díaz-Elizondo José Antonio, Flores-Villalba Eduardo, Rojas-Méndez Javier, Rodarte-Shade Mario
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto, O 3000, 64710, Monterrey, Nuevo Leon, Mexico.
Tecnologico de Monterrey, Escuela Nacional de Ingeniería, Departamento de Ciencias Clinicas, Hospital Zambrano Hellion, Batallon de San Patricio, 112. Col. Real de San Agustin, Monterrey, 66278, Mexico.
Ann Med Surg (Lond). 2021 Jan 23;62:274-277. doi: 10.1016/j.amsu.2021.01.031. eCollection 2021 Feb.
Mirizzi syndrome is an infrequent complication of long-standing cholelithiasis. Extrinsic compression of the common hepatic duct is usually caused by an impacted stone in Hartmann's pouch or cystic duct resulting in the development of cholecystobiliary fistula. This syndrome is classified based on the presence and severity of cholecystobiliary fistula. Mirizzi syndrome is challenging to diagnose preoperatively and may require complex biliary surgical procedures for resolution.
We present three patients with Mirizzi syndrome with different clinical presentations. All were successfully treated by cholangioscopy with electrohydraulic lithotripsy. Endoscopic treatment is a safe alternative with a high success rate. Single-operator cholangioscopy combined with lithotripsy has been shown to have a 90-100% success rate in the treatment of biliary stones.
Herein, we present our experience treating Mirizzi syndrome with single-operator cholangioscopy guided electrohydraulic lithotripsy. Difficult management of Mirizzi syndrome has led to research of new treatment options to minimize the risk of high-rate complications. Single-operator cholangioscopy in combination with laser lithotripsy is an adequate and safe alternative for the treatment of this condition.
Mirizzi综合征是长期胆石症的一种罕见并发症。肝总管的外在压迫通常由Hartmann袋或胆囊管内的嵌顿结石引起，导致胆囊胆管瘘的形成。该综合征根据胆囊胆管瘘的存在和严重程度进行分类。Mirizzi综合征术前诊断具有挑战性，可能需要复杂的胆道外科手术来解决。
我们报告了3例临床表现各异的Mirizzi综合征患者。所有患者均通过胆管镜下电液压碎石术成功治疗。内镜治疗是一种安全的替代方法，成功率高。单操作者胆管镜联合碎石术在治疗胆管结石方面已显示出90%至100%的成功率。
在此，我们介绍了单操作者胆管镜引导下电液压碎石术治疗Mirizzi综合征的经验。Mirizzi综合征的困难管理促使人们研究新的治疗方案，以尽量降低高并发症发生率的风险。单操作者胆管镜联合激光碎石术是治疗这种疾病的一种合适且安全的替代方法。
