Nagakawa T, Ohta T, Kayahara M, Ueno K, Konishi I, Sanada H, Miyazaki I
Second Department of Surgery (Department of Health Science), School of Medicine, Kanazawa University, Japan.
Hepatogastroenterology. 1997 Jan-Feb;44(13):63-7.
BACKGROUND/AIMS: A new classification of Mirizzi syndrome was developed based on our experience with 30 cases.
Using diagnostic and therapeutic criteria, four distinct entities were identified. Type I characterized by stenosis of the common hepatic duct due to a stone impacted in the cystic duct or the neck of the gallbladder. Type II is characterized by fistulization of the common hepatic duct as a result of a stone embedded in the cystic duct or the neck of the gallbladder. Type III is defined by hepatic duct stenosis due to a stone of the confluence, and Type IV by hepatic duct stenosis as a complication of cholecystitis in the absence of calculi impacted in the cystic duct or the neck of the gallbladder.
Of the 30 patients there were 14 Type I, 2 Type II, 6 Type III, and 8 Type IV patients. Distinctive cholangiographic features were identified.
The therapeutic approach differs from each of the four distinct pathologic entities.
背景/目的：基于我们对30例病例的经验，制定了一种Mirizzi综合征的新分类法。
采用诊断和治疗标准，确定了四种不同类型。I型的特征是由于胆囊管或胆囊颈部嵌顿结石导致肝总管狭窄。II型的特征是由于胆囊管或胆囊颈部嵌入结石导致肝总管形成瘘管。III型定义为汇合部结石导致肝管狭窄，IV型为在无胆囊管或胆囊颈部嵌顿结石的情况下，作为胆囊炎并发症的肝管狭窄。
30例患者中，I型14例，II型2例，III型6例，IV型8例。确定了独特的胆管造影特征。
四种不同病理类型的治疗方法各不相同。
