Frecuencia y características clínicas, bioquímicas e histológicas del hígado graso no alcohólico en pacientes con enfermedad litiásica vesicular / Frequency and clinical, biochemical and histological characteristics of nonalcoholic fatty liver disease in patients with gallstone disease

BACKGROUND: In 1980, nonalcoholic fatty liver disease (NALFD) was described. It is related to the genesis of gallstones and is considered as a manifestation of the metabolic syndrome. In order to determine the frequency, anatomoclinical characteristics and biochemical and histological alterations in NAFLD, patients underwent cholecystectomy (GD). For this reason, we considered carrying out this study. METHODS: This was a prospective and observational study. The study population was comprised of patients with gallstone disease who were treated at the [quot ]Hospital Español[quot ] in Veracruz, Mexico from January 1, 2005 to November 30, 2006 and underwent cholecystectomy and liver biopsy. Analyzed variables were anthropometric characteristics and risk factors, and in each patient biochemical tests, abdominal ultrasound (US) and histological liver study were performed. RESULTS: In 95 patients, according to liver biopsy diagnoses, we found a frequency of 54.74% of NAFLD associated with gallstones. Females were more affected (71.15%) and the average age was 55.6 +/- 17.87 years. Risk factors were obesity (67.3%), diabetes mellitus (17.3%), and dyslipidemia (76.92%). Patients with NAFLD had elevated levels of glucose, glycosylated hemoglobin, cholesterol, triglycerides and HDLcholesterol, and aminotransferases. Abdominal US did not show sufficient specificity and sensitivity to detect NAFLD. Histological findings showed stage I steatosis in 51.93%, stage II in 28.84% and stage III in 19.23%. Cirrhosis was found in 3.15%. DISCUSSION: Results of our study confirm the high frequency of NAFLD in association with gallstone disease. We consider this the first work to analyze and describe the primary clinical, biochemical and morphological characteristics.

Tratamiento quirúrgico laparoscópico del quiste hepático no parasitario / Surgical laparoscopic treatment of non parasitic hepatic cyst

Se presenta la experiencia de siete casos de quiste hepático no parasitario, atendidos en un periodo de siete años, comprendido de 1992 a 1998 en el Hospital Español de Veracruz. Se describen las manifestaciones clínicas, de las cuales la más importantes fue el dolor por compresión sobre los órganos adyacentes, la sensación de tumoración abdominal, y a la exploración, hepatomegalia de grado variable. El diagnóstico se realizó por ultrasonido y se confirmó por tomografía axial computada. El tamaño de los quistes fue en promedio de 14 cm, y se detectaron en 28.57 por ciento de los casos otros quistes adicionales pequeños. El tratamiento quirúrgico consistió en resección de la pared libre del quiste y electrocoagulación del interior de la cápsula residual, mediante técnica laparoscópica. No se presentaron incidentes transoperatorios, ni existió morbilidad o mortalidad relacionada al procedimiento en sí, además en todos los casos la evolución fue satisfactoria. Autores extranjeros, han reportado el tratamiento de esta entidad con técnica laparoscópica y en México, aunque se ha publicado experiencia de algunos autores con técnica abierta, no existe ninguno con cirugía de mínima invasión