Differentiated surgical tactics for Mirizzi syndrome in patients with cholelithiasis
DOI:
https://doi.org/10.11603/2414-4533.2022.1.12850Keywords:
Mirizzi syndrome, classification, diagnosis, computed tomography, retrograde cholangiopancreatography, cholecystectomy, drainage of the common hepatic ductAbstract
The aim of the work: to improve the results of treatment of Mirizzi syndrome by developing rational surgical tactics depending on its type.
Materials and Methods. The work is based on the evaluation of the results of surgical treatment of 62 patients with cholelithiasis complicated by Mirizzi syndrome who were hospitalized in surgical departments of the Republican Specialized Scientific and Practical Center for Emergency Medical Care of the Samarkand branch for the period from 2016 to 2021.
Results and Discussion. Successful radical cholecystectomy largely depends on the correctly chosen surgical tactics, which significantly affects the course of the operation and has a certain significance in the outcome of surgical treatment, affects the course of the rehabilitation period. Based on the data of the preoperative examination the patients of the main group were divided into 3 subgroups of the degree of probability of Mirizzi syndrome. The proposed program for choosing surgical tactics in patients with cholelithiasis complicated MS allowed in 8.1 % and 29.0% of cases to perform laparoscopic cholecystectomy and cholecystectomy from a mini-access, respectively, and thereby allowed to avoid damage to the bile ducts and to complete the operation with minimal risk. The developed program for choosing the tactics of surgical treatment of patients with cholelithiasis complicated MS, taking into account an integrated approach to the choice of access, allowed to improve the quality of care by reducing the frequency of immediate postoperative complications to 3.2 %, and in the long-term postoperative period, complications were reduced to zero.
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