Objectives: Mirizzi syndrome (MS) is a condition when an impacted stone in the cystic duct or the Hartmann’s pouch due to its extrinsic compression and concomitant inflammation causes an obstruction of the common bile duct. Laparotomy was the preferred surgical technique to treat this syndrome. However, with advances in technologies, an increasing number of surgeons are starting to choose minimally invasive surgery. The objective of this study is to review existing literature relating to minimally invasive surgery treatment of MS. Methods: PubMed and ClinicalKey were used to search and identify relevant articles since January 2000 to December 2020. The following keywords were applied: Mirizzi syndrome, laparoscopy, minimally invasive. The criteria for exclusion were applied: case reports with less than 2 patients, nonsurgical treatments, and reviews were excluded from this study. Results: Thirty-two articles were identified for analysis, 17 (540 patients in total) of these articles fulfilled the inclusion criteria: 8 retrospective studies, 4 case series, and 5 prospective studies. In the analyzed cohort, 295 patients were treated laparoscopically. Out of 17 articles included in the manuscript, 14 articles provided the information on minimally invasive surgery approach. There were 221 minimally invasive surgeries, out of which 143 (64.7%) were successful, thus according to the type of MS: MS I-175 (79.2%), successful 105 (60%); MS II-40 (18%), successful 32 (80%); MS III-6 (2.7%), successful 6 (100%). The mean conversion rate from laparoscopic to open surgery was 26.2% (range 0–67%), and the median complication rate in seventeen studies was 18.1% (range 0–40%), respectively. The female/male ratio was 1.2:1, and the median age in fifteen studies providing overall data on age was 57.4 years (range 40.1–70.1 years). Conclusions: Current evidence presents that open surgery remains the main treatment for MS. Minimally invasive approaches are feasible, safe, and are associated with short-term recovery, significant differences in the operation time and blood loss during operation. However, minimally invasive approaches are mainly restricted to selected patients with type I MS.
Visc Med

中文翻译：

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Mirizzi 综合征：微创手术有立足之地吗？

目的： Mirizzi 综合征 (MS) 是指胆囊管或 Hartmann 袋中的嵌塞结石由于其外在压迫和伴随的炎症导致胆总管阻塞的一种情况。剖腹手术是治疗这种综合征的首选手术技术。然而，随着技术的进步，越来越多的外科医生开始选择微创手术。本研究的目的是回顾与微创手术治疗多发性硬化症相关的现有文献。方法：使用 PubMed 和 ClinicalKey 检索和识别自 2000 年 1 月至 2020 年 12 月的相关文章。应用了以下关键词：Mirizzi 综合征、腹腔镜检查、微创。应用排除标准：少于 2 名患者的病例报告、非手术治疗和评论被排除在本研究之外。结果：确定了 32 篇文章进行分析，其中 17 篇（共 540 例患者）符合纳入标准：8 篇回顾性研究、4 篇病例系列研究和 5 篇前瞻性研究。在分析的队列中，295 名患者接受了腹腔镜治疗。在手稿中包含的 17 篇文章中，有 14 篇文章提供了有关微创手术方法的信息。微创手术221例，其中成功143例（64.7%），因此按MS类型分：MS I-175例（79.2%），成功105例（60%）；MS II-40 (18%)，成功 32 (80%)；MS III-6 (2.7%)，成功 6 (100%)。从腹腔镜手术到开腹手术的平均转化率为 26.2%（范围 0-67%），17 项研究的中位并发症发生率为 18.1%（范围 0-40%）。男女比例为1.2:1，结论：目前的证据表明，开放手术仍然是 MS 的主要治疗方法。微创方法可行、安全，恢复时间短，手术时间和术中失血量差异显着。然而，微创方法主要限于选定的 I 型 MS 患者。
维斯克医学