Objective:To explore the value of laparoscopic and endoscopic cooperative surgery with the patient lying on supine position under general anesthesia in the operation of type I Mirizzi syndrome with choledocholithiasis.Methods:From Jan 2018 to Jan 2020, 53 cases of Mirizzi syndrome with choledocholithiasis undergoing laparoscopic and endoscopic cooperative surgery (preLC+ ERCP+ EST) at the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed.Results:53 patients successfully underwent LC without conversion to open surgery, and 2 patients failed in ERCP + EST attempt, with a success rate of 96.2%. One patient developed pancreas pseudocyst as a result of post-operative hemorrhagic necrotizing pancreatitis. Two patients suffered from chronic pancreatitis. Three patients complaining postoperative upper abdominal discomfort were finally diagnosed as stump cystic duct inflammation by MRCP, and no abnormalities were found in the follow-up of the remaining cases.Conclusion:Laparoscopic and endoscopic cooperative surgery in the treatment of patients with type I Mirizzi syndrome combined with choledocholithiasis is minimally invasive and effective.

Hepatocellular carcinoma (HCC) is a common malignant tumor with poor prognosis, and surgical resection is the preferred method for the treatment of HCC, but it has a limited therapeutic effect on advanced HCC, while systemic treatment plays an important role in the treatment of advanced unresectable HCC. This article summarizes the advances in systemic therapy for unresectable liver cancer in China and globally in recent years, including a variety of tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib, and cabozantinib) and immune checkpoint inhibitors (atezolizumab, pembrolizumab, and nivolumab). The analysis shows that for patients with unresectable HCC, systemic therapy can prolong the survival time of patients to a certain extent, and combined treatment regimen has become a new research hotspot. Individualized systemic treatment strategies will be further explored in the future.