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微创治疗 Mirizzi 综合征 Va 型:病例系列及文献综述。

Minimally invasive management of Mirizzi syndrome Va: Case series and narrative review of the literature.

机构信息

Departamento de Cirugía Laparoscópica Avanzada, Universidad Militar Nueva Granada, Bogotá, Colombia.

Cirugía General, Universidad El Bosque, Bogotá, Colombia.

出版信息

Cir Esp (Engl Ed). 2022 Jul;100(7):404-409. doi: 10.1016/j.cireng.2022.04.024. Epub 2022 May 4.

Abstract

INTRODUCTION

Mirizzi's Syndrome (MS) is a rare pathology, known to be a challenge for the surgeon. In the surgical management, open approach vs laparoscopic is a topic of discussion due to anatomic variations. The aim of this study is to analyze our experience in the laparoscopic management of this condition in Type Va.

METHODS

We made a descriptive retrospective study of patients diagnosed with MS type Va and treated by laparoscopic approach from 2014 to 2019, in two high volume centers of Bogotá, Colombia.

RESULTS

1073 patients who presented complications from gallstones were evaluated, of which 16 were diagnosed with MS type Va. 75% were females and 25% males; 80% presented jaundice and 90% abdominal pain; 12 patients showed cholecystoduodenal fistula and 4 cholecystocolic fistula. All patients underwent laparoscopic management, total cholecystectomy and fistula resection with primary closure was possible on a 100% of the patients. Conversion rate was 0%. The follow up was 18 months.

CONCLUSION

Laparoscopic management of MS is feasible and safe; the experience of the surgery group and selection of the patients is the key to a successful outcome.

摘要

简介

Mirizzi 综合征(MS)是一种罕见的病理,对外科医生来说是一个挑战。在手术管理中,开放方法与腹腔镜方法的选择是一个讨论的话题,这是由于解剖变异所致。本研究旨在分析我们在哥伦比亚波哥大两个高容量中心对 Va 型 MS 患者进行腹腔镜治疗的经验。

方法

我们对 2014 年至 2019 年间通过腹腔镜方法诊断为 MS 型 Va 并接受治疗的患者进行了描述性回顾性研究。

结果

评估了 1073 例因胆结石引起并发症的患者,其中 16 例诊断为 MS 型 Va。75%为女性,25%为男性;80%有黄疸,90%有腹痛;12 例患者显示胆囊十二指肠瘘,4 例显示胆囊结肠瘘。所有患者均接受腹腔镜治疗,100%的患者可行胆囊切除术和瘘管切除术,行一期缝合。转换率为 0%。随访时间为 18 个月。

结论

MS 的腹腔镜治疗是可行和安全的;手术组的经验和患者的选择是成功的关键。

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