[Diagnostics and surgical tactics for Mirizzi syndrome].

Analysis of clinical investigation and surgical treatment of 284 patients with Mirizzi syndrome (MS) was carried out. According to A.Csendes and co-authors classification (1989) 223 patients had the I type of MS, 49 patients--the II type, 9 patients--the III type, 3 patients--the IV type. Diagnosis was ascertained before the operation in 27.4% of patients; with the help of ultrasound study--in 9.1%, by means of retrograde cholangiopancreatography--in 18.3%. In other cases diagnosis was determined during the operation. Mode of the operation depended on the type of MS. Perioperative duct damage was signed in 4 cases (1.4%). Laparoscopic cholecystectomy (LCE) was carried out to 56 patients; cholecystectomy from mini-access--to 41 patients. Remaining 187 patients underwent abdominal operation. In 2 cases operation was finished by external duct drainage; in 7 Roo choledochojejunostoma was formed. Authors suggest that the I type of MS is not a contra-indication for LCE. In case of difficulties in LCE switch to cholecystectomy from mini-access is preferable.