Clinical efficacy of laparoscopic surgery combined with T-tube drainage for patients with Mirizzi syndrome

  Objective  To evaluate the clinical efficacy of laparoscopic surgery combined with T-tube drainage in patients with Mirizzi syndrome.

  Methods  A total of 60 patients with Mirizzi syndrome who were treated in our hospital were divided into control group (n=28)and laparoscopic group (n=32) according to different surgical methods. The control group was treated with open cholecystectomy combined with T-tube drainage, and the laparoscopic group was treated with laparoscopic surgery combined with T-tube drainage. The surgical results, follow-up results, and incidence of complication of the two groups were analyzed. Perioperative clinical indicators including operative time, intraoperative blood loss, drainage time, hospital stay, postoperative exhaust time and postoperative satisfaction were compared between the two groups.

  Results  The operations of both groups were successfully completed. Out of the 32 patients in the laparoscopic group, 5 patients were converted to open surgery due to more serious adhesions in the gallbladder triangle. There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05). The results of followed up showed that the patients used T-tube drainage for 3 to 6 months after operation. Angiography showing that bile duct was unobstructed, the catheter was extubated after observing the tube was normal. There were no occurrence of biliary tract, gallstones, and common bile duct stricture during the follow-up in the two groups, and they had better prognosis. The intraoperative blood loss, hospital stay and postoperative exhaust time in the laparoscopic group were significantly better than those in the control group (P < 0.05). There were no significant differences in the operation time and drainage time between the laparoscopic group and the control group (P>0.05). The satisfaction of the laparoscopic group was significantly higher than that of the control group (P < 0.05).

  Conclusion  The biliary structures of patients with type Ⅱ and Ⅲ Mirizzi syndrome are complicated, which cause a higher risk of postoperative complications. Preoperative classifications of patients with Mirizzi syndrome should be done to determine the surgical procedure and surgical risk to reduce the incidence of conversion to open surgery, biliary tract injury and related complications, and to improve the prognosis of patients.