Coledocolitiasis y exploración laparoscópica de la vía biliar. Un estudio de cohorte

Palabras clave: conducto colédoco, coledocolitiasis, procedimientos quirúrgicos mínimamente invasivos, laparoscopía, coledocoscopia, colangiopancreatografia retrógrada endoscópica

Resumen

Introducción. La coledocolitiasis es la presencia de cálculos en las vías biliares. En la mayoría de los casos se trata mediante la colangio pancreatografía retrógrada endoscópica y menos comúnmente por intervención quirúrgica laparoscópica. El objetivo de este estudio fue describir una cohorte retrospectiva de pacientes sometidos a exploración laparoscópica de la vía biliar.

Métodos. Se incluyeron pacientes intervenidos entre los años 2014 y 2018, en dos instituciones de nivel III en Cali, Colombia, referidos para valoración por cirugía hepato-biliar, por dificultad para la extracción de los cálculos por colangio pancreatografia retrograda endoscópica, debido al tamaño, la cantidad, o la dificultad para identificar o canular la papila duodenal.

Resultados. De los 100 pacientes incluidos, se encontró que el 72 % fueron mujeres, con rango de edad entre 14 y 92 años. Al 39 % de los pacientes se les extrajo un solo cálculo y al 16 % 10 cálculos. Un 12 % presentaron cálculos gigantes (mayores de 2,5 cm de ancho) y un 44 % presentaron litiasis múltiple. Al 69 % de los pacientes se les realizó colecistectomía. El porcentaje de éxito de limpieza de la vía biliar por laparoscopia fue del 95 %.

Discusión. La exploración laparoscópica de la vía biliar es una técnica posible, reproducible, segura y con excelentes resultados para el manejo de la coledocolitiasis.

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Biografía del autor/a

Luis Fernando Álvarez-Chica, Centro Médico Imbanaco, Cali, Colombia.

Médico, especialista en Cirugía general, Cirugía laparoscópica avanzada y Gastroenterología clínico quirúrgica, Centro Médico Imbanaco, Cali, Colombia.

Juan Manuel Rico-Juri, Centro médico Imbanaco, Cali, Colombia.

Médico, especialista en Cirugía general y Cirugía hepato biliar y de trasplantes, Centro médico Imbanaco, Cali, Colombia.

Sonia Alejandra Carrero-Rivera, Centro Médico Imbanaco, Cali, Colombia.

Médico, especialista en Cirugía general y Cirugía de trasplantes, Centro médico Imbanaco, Cali, Colombia.

Felipe Castro-Villegas, Centro Médico Imbanaco, Cali, Colombia.

Médico, especialista en Cirugía general y Cirugía de trasplantes, Centro médico Imbanaco, Cali, Colombia.

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Publicado
2021-03-09
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alvarez chica, luis fernando; Rico-Juri, J. M.; Carrero-Rivera, S. A.; Castro-Villegas, F. Coledocolitiasis Y exploración laparoscópica De La vía Biliar. Un Estudio De Cohorte. Rev Colomb Cir 2021, 36, 301-311.
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