[Diagnostics and surgical tactics for Mirizzi syndrome].
Analysis of clinical investigation and surgical treatment of 284 patients with Mirizzi syndrome (MS) was carried out. According to A.Csendes and co-authors classification (1989) 223 patients had the I type of MS, 49 patients--the II type, 9 patients--the III type, 3 patients--the IV type. Diagnosis was ascertained before the operation in 27.4% of patients; with the help of ultrasound study--in 9.1%, by means of retrograde cholangiopancreatography--in 18.3%. In other cases diagnosis was determined during the operation. Mode of the operation depended on the type of MS. Perioperative duct damage was signed in 4 cases (1.4%). Laparoscopic cholecystectomy (LCE) was carried out to 56 patients; cholecystectomy from mini-access--to 41 patients. Remaining 187 patients underwent abdominal operation. In 2 cases operation was finished by external duct drainage; in 7 Roo choledochojejunostoma was formed. Authors suggest that the I type of MS is not a contra-indication for LCE. In case of difficulties in LCE switch to cholecystectomy from mini-access is preferable.
Greiasov
V I
VI
Perfil'ev
V V
VV
Shchepkin
S P
SP
Petrichenko
A V
AV
Sivokon'
N I
NI
Chuguevskiĭ
V M
VM
D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000379:methods*; D002764:Cholecystitis / Q000150:complications* / Q000000981:diagnostic imaging; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D014463:Ultrasonography