POSSIBILITIES OF EARLY DIAGNOSIS AND PROPHYLAXIS OF INTRAOPERATIVE BILE DUCT LESIONS IN MIRIZZY SYNDROME

  • B. S. Zaporozhchenko
  • D. A. Bondarets
  • I. E. Borodaev
  • I. V. Sharapov
  • A. Yu. Sharapova
Keywords: Mirizzy syndrome, laparoscopy, cholecystectomy, cholelithiasis.

Abstract

Summary. Goal. To analyze the possibilities of early diagnosis and prevention of intraoperative injuries of the bile duct in the Mirizzy syndrome.

Materials and research methods. The study is based on an analysis of 968 case histories of patients with acute calculous cholecystitis. The ratio of patients with Mirizzy syndrome to patients with calculous cholecystitis was 38 (3.9 %). There were 716 women (74 %), and 252 men (26 %). The age of patients ranged from 25 to 92 years.

All patients with Mirizzy syndrome were divided into 4 groups (according to the classification of A. Csendes). The number of patients with type 1 SM was 27 (72 %); 2 types — 6 (18 %); 3 types — 2 (6 %); 4 types — 1 (3 %).

Result. The treatment outcome of 35 patients with Mirizzy syndrome was evaluated. In type 1, LCE was performed in 27 (72 %) patients. In type 2, open surgery was performed. In 4 (12 %) patients of this group, a laparotomy was performed for cholecystectomy with plastic surgery of the common bile duct on Keru drainage. In 2 (6 %), subtotal cholecystectomy was performed with subsequent installation of drainage into the lumen of the remaining part of the bladder with fistula. In the presence of types 3 and 4 of Mirizzy’s syndrome, an “open” surgical intervention was performed, followed by hepaticojejunoanastomosis on the Loop-off loop in 3 (9 %) patients. The most informative non-invasive method of preoperative diagnosis of Mirrisi syndrome is MRI in cholangiography, which allows you to diagnose all types of this syndrome with a high degree of probability.

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Published
2020-04-20
How to Cite
Zaporozhchenko, B. S., Bondarets, D. A., Borodaev, I. E., Sharapov, I. V., & Sharapova, A. Y. (2020). POSSIBILITIES OF EARLY DIAGNOSIS AND PROPHYLAXIS OF INTRAOPERATIVE BILE DUCT LESIONS IN MIRIZZY SYNDROME. Kharkiv Surgical School, (2), 49-52. https://doi.org/10.37699/2308-7005.2.2020.10
Section
QUESTIONS OF SURGERY OF PANCREATOBILIARY SYSTEM