Mirrizi综合征的治疗原则与策略

Therapeutic principles and strategies of Mirrizi syndrome

  • 摘要: Mirrizi综合征是胆道外科少见良性疾病。随着疾病诊断与治疗领域新理念、新技术的不断涌现,胆道疾病的规范化诊断与治疗不断更新。Mirrizi综合征术前诊断困难,术中因胆囊炎症、胆囊瘘道形成导致胆囊三角解剖不清晰、组织粘连,增加了发生胆道损伤风险,其手术治疗目前仍具有挑战性。因此,严格的术前评估,针对Mirrizi综合征不同分型选择相应的手术方式,对减少患者术后并发症具有重要意义。此外,随着腹腔镜技术的发展,可减少手术创伤并加快康复,但同时对外科医师的经验及手术操作提出了更高要求。合理选择腹腔镜手术指征,正确把握胆肠吻合手术适应证,在取尽结石的基础上减少医源性胆管损伤,也是手术治疗Mirrizi综合征的基本策略。笔者查阅相关文献并结合临床实践,探讨Mirrizi综合征的治疗原则与策略。

     

    Abstract: Mirrizi syndrome is a rare benign disease of biliary tract. With the continuous emergence of new concepts and technologies in the field of disease diagnosis and treatment, the standardization of diagnosis and treatment for biliary diseases is also updated. Mirrizi syndrome is difficult to be diagnosed pre-operatively,and intraoperative unclear Calot′s triangle and tissue adhesion caused by gallbladder inflammation and gallbladder fistula formation increase the risk of biliary tract injury, which lead certain challenges for its surgical treatment. Therefore, strict preoperative evaluation and selection of corresponding surgical procedure for different classification of Mirrizi syndrome are of great significance for reducing postoperative complications. In addition, the development of laparoscopic technology reduces the surgical trauma and enhances recovery, but puts forward higher requirements for the experience and operation of surgeons. It is important that reasonably select laparoscopic surgery indications, correctly hold indications of bilioenetric anastomosis, and prevent iatrogenic injury of bile duct on the premise of clearing stones, which is the basic strategy for surgical treatment of Mirrizi syndrome. Based on relevant literatures and clinical practice,the author investigate the therapeutic principles and strategies of Mirrizi syndrome.

     

/

返回文章
返回