PREOPERATIVE DIAGNOSIS OF MIRIZZI SYNDROME
DOI:
https://doi.org/10.11603/2414-4533.2019.4.10703Keywords:
Mirizzi syndrome, ultrasound, endoscopic retrograde cholangiopanreatography, computer tomography, magnetic resonance imaging, panreatocholangiographyAbstract
The aim of the work: definition of the effectiveness of different methods of preoperative diagnosis of Mirizzi syndrome.
Materials and Methods. An analysis of 8100 patients with gallstone disease was performed. The incidence of spontanous internal biliar fistulas(SIBF) was 2.5 % (202 patients). 80 (39.6 %) patients were diagnosed with type I of MS and 128 (60.4 %) patients with MS type II(II-V). There were 66 men (31.7 %), 136 women (68.3 %). Patients’ age ranged from 37 to 80 years (average 66.4 years). All patients were examined using modern diagnostic methods, such as: abdominal ultrasound, on a device Voluson 730 Pro rus; spiral CT scan of the abdominal cavity at Somatom Emotion Siemens; ERCP; magnetic resonance imaging (MRI) of the abdomen and MRI. During the presentation of the results of clinical and laboratory studies, the determination of diagnostic specificity, sensitivity and effectiveness of the diagnostic method was performed.
Results and Discussion. The presence of complicated clinical forms in patients with MS was the basis for conducting a comprehensive examination using various methods of pre-operative diagnosis. According to the results, magnetic resonance cholangiopancreatography with efficacy of 84 % (MS I) and 90 % (MS II–V) is the most effective method of pre-operative diagnosis of Mirizzi I and II type syndrome. In the second place in terms of diagnostic efficiency is endoscopic retrograde cholangiopancreatography, where the efficiency for type I MS is 75.6 % and for type II MS is 81 %. The efficacy of the ultrasound examination method for patients with type I media was 55 % and 68.8 % for patients with type II CM. СT with the efficiency of 30 % and 61 % respectively was found to be the least effective method of pre-operative MS diagnosis.
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