SURGICAL MANAGEMENT OF MIRIZZI'S SYNDROME

Abstract

Complicated gallstone disease causes operative difficulties despite surgeon's experience and patient's examination. We have an experience of surgical management in patients with Mirizzi's syndrome (MS) that made3,2% from a total number of operated patients with cholelithiasis (women 74%, men 26%). Patient's age was from 28 to93years old.We want to stress that the final form of MS is defined only during surgery. We distinguish only 2 forms of MS without sharing according to involvement of common bile duct into destructive-and-inflammatory process.In 45% of patients I form of MS was registered, in 55% - II form. In MS-I the preferable surgery is cholecystectomy with outer bile ducts draining. Plasty of hepatocholedochus in MS-I is indicated for proved duct stricture. MS-II is the indication for performing different restorative or reconstructive surgery dependent on intraoperative data (application of primary suture on common bile duct, plasty of hepatocholedochus with the gallbladder wall, choleedochoduodenostomy, hepaticocholedochostomy, hepaticojejunostomy).