Mirizzi syndrome (MS) represents a rare clinical entity, being a challenge in biliary tract surgery. However, recent advances in technology have provided surgeons with new options for timely diagnosis and surgical treatment. Mirizzi syndrome currently has an incidence of 1%, representing 0.7-1.4% of all cholecystectomies performed. The study group included 73 patients treated in the clinic during the years 2000-2022, with attestation of the prevalence of type II MS. A combination of two or more diagnostic techniques increased the rate of preoperative diagnosis. The treatment was exclu- sively surgical adopted for the type of MS. Optimizing the methods of diagnosis and surgical treatment allows to increase the rate of objectification of the diagnosis and the choice of the surgical technique depending on the type of MS favoring the postoperative evolution.
Objectives. Surgical management of patients with benign biliary strictures and biliary lesions is a current issue for discussion and raises many scientific research directions. The purpose of this study was to systematize our experience in the treatment of benign biliary strictures, analyzing both immediate and remote complex results. . Clinical evaluation included several consecutive steps: 1) setting the etiopathogenic diagnosis; 2) pre-operatory decompression of the biliary tree; 3) reconstructive surgical act. In the case of biliary strictures, after the initial assessment, biliodigestive derivations were performed according to the level of the obstacle, preferring the bilio-jejunal anastomosis with a Roux-en-Y excluded loop. The post-operatory mortality was 2.63%. Conclusions. The iatrogenic stricture of bile duct has a complicated evolution, with many surgeries, requiring many hospitalizations. It should be endeavored to detect them in a timely manner and to prevent septic complications. In the first phase, biliary tree decompression will be used, and after decreasing the inflammatory process biliary-digestive reconstruction will be performed. These patients require a complex remote monitoring and analysis of health status.
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