Surgical Tactics for Mirizzy’s Syndrome
¹Tashkent Medical Academy; ²Republican Research Centre of Emergency Medicine; ³Tashkent Institute of Postgraduate Medical Education; Tashkent, Uzbekistan.
*Corresponding author: Farkhad A. Khadjibaev, MD, PhD. Tashkent Medical Academy Tashkent, Uzbekistan. E-mail: firstname.lastname@example.org
Published: June 22, 2014.
Surgery performed when there are urgent indications is still the main treatment method for patients with Mirizzi’s syndrome (MS). However, surgical correction often leads to the development of a post-operative stricture of the hepaticocholedoch, which requires complex reconstructive operative interventions at a later time. 93 patients (aged from 27 to 74 years) with MS were treated during 8 years. According to the presence of obstructive jaundice (OJ), the treatment process of the patients was divided into two stages. The first stage started with performing endoscopic diagnostic and operative interventions as retrograde pancreatico-cholangiography (RPCG) with endoscopic papillosphincterotomy (EPCT) and, in cases of inefficiency, the use of percutaneous–transhepatic cholangiostomy (PTChS) was applied. In 39 patients, due to the presence of severe concomitant pathology and high operative risk, the first treatment stage was the final one. Altogether, we operated on 54 patients in the second stage. The results obtained showed that the diagnostic process in patients with gallstones complicated by fistula must be complex, and the leading role should belong to endoscopic means of investigation with high indications of specificity, sensitivity, and general exactness. Operative interventions in patients with MS must be performed in two stages: in the first stage, decompression of the biliary system is performed; in the second stage, adequate bile passage into bowels is recovered.
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Int J Biomed. 2014; 4(2):85-88. © 2014 International Medical Research and Development Corporation. All rights reserved.