Mirizzi症候群とconfluence stone手術症例の検討

DOI 被引用文献2件

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タイトル別名
  • Mirizzi syndrome and confluence stone

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Seven cases of Mirizzi syndrome and seven case of confluence stone were operated on between 1973 and 1986.<BR>The incidence o f these complication of cholelithiasis is 0.35% respectively in non malignant biliary tract disease.<BR>Mirizzisy ndrome is sometimes difficult to be differentiated from the malignant lesion of gallbladder and bile duct preoperatively becouse of persistent jaundice and chronic inflammation. But ERCP and FTC play a diagnostic role by visualizing broad curved impression on the lateral aspect of bile duct.<BR>At operation, adhesion was strikingly dense, there is major difficulty in dissecting the gallbladder neck from the main bile duct.<BR>In confluence stone, the preoper a tive diagnosis is rare because of no paticular clinical picture. At operation, the gallbladder, fused to the main duct, was difficult to dissect from it and sometimes the cystic duct can not be isolated. A T-tube was inserted through the fistula in 4 cases and through the intact bile duct in one after partial cholecystectomy. In one case, the defect of main bile duct wall was closed by utilizing the proximal part of the gallbladder, and in one case a hepatojejunostomy was performed because the tissue loss was too great to close the bile duct primarily.

収録刊行物

  • Tando

    Tando 3 (2), 195-201, 1989

    Japan Biliary Association

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