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遺留膽囊管造成總肝管阻塞：Mirizzi症候群
Common Hepatic Duct Obstruction by Remnant Cystic Duct Stone after Cholecystectomy: Mirizzi Syndrome
摘要
膽囊切除手術後剩餘膽囊管因結石合併發炎間接壓迫到總肝管所引起的阻塞性黃疸，是很少見的。1948年Mirizzi的報告指出，膽囊頸或膽囊管的結石及發炎壓迫到總肝管引起阻塞性黃疸稱為Mirizzi症候群。當膽囊管與總肝管有一長的平行過程時又有低位附著的情況下，在膽囊切除手術中有可能留下較長的膽囊管。留下的膽囊管逐漸擴張、膽汁滯留、慢性發炎和結石形成，所引起的Mirizzi症候群者非常少見。我們發現一例膽囊切除後，因為殘留過長的膽囊管內含結石合併發炎而引起總肝管完全阻塞的病例，且經手術證實。
並列摘要
The Mirizzi syndrome is an uncommon cause of obstructive jaundice. In 1948, Mirizzi characterized a syndrome in which common hepatic duct obstruction occurs because of impacted stones in the gallbladder neck or cystic duct. It is commonly referred to date as the Mirizzi syndrome. Patients with lower insertion of the cystic duct and a long parallel course of cystic duct and common hepatic duct are often left with a long cystic duct remnant after cholecystectomy. The remnant may gradually increased in size and become a site of bile stasis, chronic inflammation, and stone formation. We report a case whose obstructive jaundice after laparoscopic cholecystectomy results from residual stone in the cystic duct remnant.