目的总结Mirizzi综合征的临床特点和诊治经验，探讨提高Mirizzi综合征患者术前确诊率的方法。方法回顾性分析21例Mirizzi综合征患者临床资料。结果术前确诊7例，术中确诊14例。按Csendes分型，Ⅰ型14例，行胆囊切除术8例，胆囊大部分切除加残余胆囊颈部黏膜烧灼2例，胆囊切除加胆总管探查、T管引流术4例； Ⅱ型5例，均行胆囊切除加胆管成形、T管引流术； Ⅲ型2例，1例行胆囊切除加胆管成形、T管引流术，另1例行胆总管空肠Roux-en-Y吻合术。随访6个月~5年，18例临床效果良好。结论胆囊管的解剖变异、胆囊颈或管部结石嵌顿、Calot三角的炎症、粘连等均可单独或合并导致Mirizzi综合征，术前确诊率的提高依赖于对临床资料的综合分析； 治疗应依据病理特点选择个体化手术方案。
Objective To study the curative effect of operative and interventional treatment in 78 cases of BuddChiari syndrome (BCS). Methods Among these patients, percutaneous transinferior vena cava angioplasty (PTA) was performed in 18 cases, PTA and stent in 10 cases, splenopneumopexy plus pedicled omento-pneumopexy of the left lower lobe in 20 cases, combined transcardiac membranotomy and transfemoral venous ballon dilatation and stent in 15 cases, right atrium-inferior vena cava shunt in 10 cases, and radical operation plus stent in 5 cases. Results After the treatment, the descent of inferior vena cava (IVC) pressure from 2.50～3.95 kPa to 1.41～2.33 kPa, the descent of portal venous pressure from 3.63～5.00 kPa to 2.16～3.23 kPa were observed. Conclusion The authors consider that PTA is the first choice for localized lesions, the following method is the operation combined with interventional treatment.