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Abstract：
Mirizzi syndrome is a complication of gallstone disease caused by an impacted gallstone in the infundibulum of the gallbladder or within the cystic duct, causing chronic inflammation and extrinsic compression of the common hepatic duct or common bile duct. Eventually, mucosal ulceration occurs and progresses to cholecystobiliary fistulation. Numerous systems exist to classify Mirizzi syndrome, with the Csendes classification widely adopted. It describes five types of Mirizzi syndrome according to the presence of a cholecystobiliary fistula and its corresponding severity, and whether a cholecystoenteric fistula is present. The clinical presentation of Mirizzi syndrome is non-specific, and patients typically have a longstanding history of gallstones. It commonly presents with obstructive jaundice, and can mimic gallbladder, biliary, or pancreatic malignancy. Achieving a preoperative diagnosis guides surgical planning and improves treatment outcomes. However, a significant proportion of cases of Mirizzi syndrome are diagnosed intraoperatively, and the presence of dense adhesions and distorted anatomy at Calot\'s triangle increases the risk of bile duct injury. Cholecystectomy remains the mainstay of treatment for Mirizzi syndrome, and laparoscopic cholecystectomy is increasingly becoming a viable option, especially for less severe stages of cholecystobiliary fistula. Subtotal cholecystectomy is feasible if total cholecystectomy cannot be performed safely. Additional procedures may be required, such as common bile duct exploration, choledochoplasty, and bilioenteric anastomosis. Conclusions: There is currently no consensus for the management of Mirizzi syndrome, as the management options depend on the extent of surgical pathology and availability of surgical expertise. Multidisciplinary collaboration is important to achieve diagnostic accuracy and guide treatment planning to ensure good clinical outcomes.
摘要：
Mirizzi综合征是由胆囊漏斗或胆囊管内的结石受累引起的胆结石疾病的并发症，引起慢性炎症和肝总管或胆总管的外在压迫。最终,粘膜溃疡发生并发展为胆囊胆管瘘。存在许多系统来分类Mirizzi综合征，与Csendes分类被广泛采用。它根据胆囊胆管瘘的存在及其相应的严重程度描述了五种类型的Mirizzi综合征，以及是否存在胆囊肠瘘。Mirizzi综合征的临床表现是非特异性的，患者通常有长期的胆结石病史。它通常表现为阻塞性黄疸，可以模仿胆囊，胆道,或胰腺恶性肿瘤.实现术前诊断指导手术计划并改善治疗结果。然而,相当比例的Mirizzi综合征病例在术中诊断，卡洛三角处致密粘连和解剖结构扭曲的存在会增加胆管损伤的风险。胆囊切除术仍是Mirizzi综合征治疗的主要手段,腹腔镜胆囊切除术越来越成为一种可行的选择，特别是对于不太严重的胆囊胆管瘘。如果不能安全地进行全胆囊切除术，则全胆囊切除术是可行的。可能需要额外的程序，如胆总管探查术,胆道成形术,和胆肠吻合术.结论：目前对Mirizzi综合征的治疗尚无共识，因为管理选择取决于手术病理的程度和手术专业知识的可用性。多学科协作对于实现诊断准确性和指导治疗计划以确保良好的临床结果非常重要。
