Gorini P, Fogli L, Belcastro S
USL n. 31, Ferrara Ospedale Civile F. lli Borselli, Bondeno, Ferrara.
Minerva Chir. 1994 Jul-Aug;49(7-8):729-31.
This paper describes the clinical course of a 76-year-old woman surgically treated in our department (General Surgery) for obstructive jaundice in Mirizzi syndrome (II). Ultrasonography and ERCP failed to demonstrate the pathological situation at the level of the biliary tree. When laparotomy was decided because of the progressive worsening of the general clinical conditions of the patient, intraoperative cholangiography showed the presence of a cholecystocholedochal fistula with multiple residual stones eroded into the common bile duct. Surgical management consisted of partial cholecystectomy, removal of the stones, choledochoplasty and exploration of the distal part of the common bile duct by a transduodenal sphincteroplasty. The post-operative period was uneventful and the patient was discharged from our department nine days after surgery. Even though the surgical approach to Mirizzi syndrome generally includes procedures other than papillosphincteroplasty+partial cholecystectomy, our experience seems to substantiate the efficacy of the previously mentioned treatment under suitable conditions.
本文描述了一名76岁女性在我院（普通外科）接受手术治疗Mirizzi综合征（II型）所致梗阻性黄疸的临床过程。超声检查和内镜逆行胰胆管造影（ERCP）未能显示胆道系统的病理情况。由于患者一般临床状况逐渐恶化而决定行剖腹手术，术中胆管造影显示存在胆囊胆总管瘘，有多颗残留结石侵蚀入胆总管。手术处理包括部分胆囊切除术、结石清除、胆管成形术以及经十二指肠括约肌成形术探查胆总管远端。术后恢复顺利，患者术后9天从我院出院。尽管Mirizzi综合征的手术方式通常包括乳头括约肌成形术和部分胆囊切除术以外的其他手术，但我们的经验似乎证实了上述治疗在合适条件下的有效性。
