England R E, Martin D F
Department of Radiology, South Manchester University Hospitals, NHS Trust, Withington.
Gut. 1997 Feb;40(2):272-6. doi: 10.1136/gut.40.2.272.
The accepted management of Mirizzi's syndrome is surgical, but endoscopic and percutaneous management have been described.
To review our experience of endoscopic intervention for Mirizzi's syndrome.
ERCP reports of patients presenting for endoscopic management of choledocholithiasis between March 1989 and June 1995 were reviewed. Those with cholangiographic evidence of Mirizzi's syndrome were selected for study. Patient records and cholangiograms were reviewed and follow up was recorded from the notes or by telephone contact with patients, their relatives, or doctors.
Twenty five patients had Mirizzi's syndrome. Sixteen were female and their median age was 67 years (range 28-91). Ten presented with painless jaundice, nine with painful jaundice, four with cholangitis, and two had pain as their only symptom. Twelve were referred for surgery and 11 of these had preliminary endoscopic therapy. Thirteen have been treated solely with endoscopic therapy. Treatment in this group was aimed at relieving jaundice and removing stones. Stones were completely removed in three patients. Nine patients have been treated with long term stents, and one awaits extracorporeal shockwave lithotripsy of the gall bladder. Complications of treatment occurred in four of 25 after ERCP.
Endoscopic treatment of Mirizzi's syndrome is effective as a temporising measure before surgery and can be definitive treatment for unsuitable surgical candidates.
公认的Mirizzi综合征的治疗方法是手术治疗，但也有内镜和经皮治疗的报道。
回顾我们对Mirizzi综合征进行内镜干预的经验。
回顾了1989年3月至1995年6月期间因胆总管结石接受内镜治疗的患者的ERCP报告。选择有Mirizzi综合征胆管造影证据的患者进行研究。查阅患者记录和胆管造影，并通过病历记录或与患者、其亲属或医生电话联系进行随访记录。
25例患者患有Mirizzi综合征。16例为女性，中位年龄67岁（范围28 - 91岁）。10例表现为无痛性黄疸，9例为疼痛性黄疸，4例为胆管炎，2例仅以疼痛为唯一症状。12例被转诊进行手术，其中11例接受了初步内镜治疗。13例仅接受了内镜治疗。该组治疗旨在缓解黄疸和取出结石。3例患者结石被完全取出。9例患者接受了长期支架治疗，1例等待胆囊体外冲击波碎石术。25例患者中有4例在ERCP后出现治疗并发症。
Mirizzi综合征的内镜治疗作为手术前的临时措施是有效的，对于不适合手术的患者也可以作为确定性治疗。
