Diagnosis and treatment of Mirizzi syndrome.docVIP

 PAGE \* MERGEFORMAT 15 Diagnosis and treatment of Mirizzi syndrome Keywords: Diagnosis and treatment of Mirizzi syndrome Mirizzi syndrome (Mirizzi syndrome.MS) is caused by a gallstone functional bile duct syndrome in clinical practice is less common [1]. Since 1948, Mirizzi after the first report of intraoperative cholangiography disease has been reported at home and abroad are increasingly in diagnosis and treatment. In order to guide clinical diagnosis and choice of a reasonable surgical, summarized below. 1 Mirizzi syndrome, the pathological Mirizzi syndrome anatomy, because of the cystic duct and the hepatic duct in parallel, in the cystic duct or gallbladder neck calculi incarcerated on the basis of repeated inflammation, the mechanical compression caused by hepatic duct or cystic duct stenosis, obstruction, due to chronic focal necrosis , and even between the cystic duct and the hepatic duct fistula formation. Caused by biliary stones, cholangitis, and a series of pathological changes, clinical symptoms including impaired liver function, including infarction jaundice, repeated upper abdominal pain, chills, fever and other manifestations of inflammation of biliary tract stones. Diederich [2] that the cystic duct is too long, and in parallel with the hepatic duct anatomical variant is a necessary condition for this disease. Didlake [3] that the cystic duct openings are too low, or parallel to the hepatic duct, and sometimes absence of two adjacent walls, and sometimes only a fibrous membrane, stone impaction in the cystic duct, hepatic duct pressure to make it easier to narrow, and even the formation of fistula, This is the pathological features of this disease. Mirizzi syndrome pathological types: 1982 Mcsherry under retrograde cholangiopancreatography (ERCP) performance will be divided into I-and II-type, I type is incarcerated stone in the cystic duct or gallbladder neck, the right hepatic duct with curved filling