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VOLUME 04 ISSUE 04 APRIL 2021

Treatment Methods for Different Variations Syndrome Mirizzi
1Omarov N.B., 2Aimagambetov M. Zh.,3Abdrakhmanov S.T.,4 Auenov M.A.,5Lazarev A.K., 6Akparov T.L.,7 Akhmetzhanova D.O.
1,2,3,4,5,6,7Department of Hospital Surgery, NJSC "MUS", Semey, Republic of Kazakhstan
DOI : https://doi.org/10.47191/ijmra/v4-i4-20

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ABSTRACT:

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts.

The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed:


1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1);
2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1).

The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology.

These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).

KEYWORDS

Complications of cholecystectomy, Mirizzi syndrome, acute calculous cholecystitis, acute calculous cholecystitis and overweight, surgical treatment, cholecystectomy by mini-access, hepatic choledochojejunostomy, cholecystohepatic choledochoplasty.

REFERENCES

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7) Siplivy VA, Evtushenko DV, Petrenko GD, Andreeshchev SA, Evtushenko AV Diagnostics and surgical treatment of Mirizzi syndrome. Clinical practice. - 2016. - No. 8. - S. 8-11.

8) Kulezneva Yu.V., Plyusnin B.I., Lyuosev S.V. et al. Modern technologies in the diagnosis and treatment of Mirizzi syndrome // Ros. honey. messenger. - 2008. - T 13, No. 4. - S. 61-66.

9) Styazhkina S.N., Valinurov A.A., Shabardin A.M., Ayupov A.I. Results of the analysis of the peculiarities of diagnostics and surgical treatment of acute and chronic calculous cholecystitis // Electronic scientific and educational bulletin "Health and education in the XXI century." 2016. Vol. 18. No. 2. S. 129-131.

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13) 16. Vorobey A.V., Orlovsky Y.N., Vizhinis E.I., Shuleyko A.C. Surgical Treatment of Biliobiliary and Biliodigestive Fistulas. Annaly khirurgicheskoy gepatologii = Annalsof HPB surgery. 2016; 21 (3): 92-100.

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VOLUME 04 ISSUE 04 APRIL 2021

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