Manejo mini-invasivo de la litiasis coledociana / MINIMALLY INVASIVE SURGERY OF CHOLEDOCHOLITHIASIS
Prensa méd. argent
;
104(2): 79-92, 20180000. cua
Artigo
em Espanhol
| LILACS, BINACIS
| ID: biblio-1370668
ABSTRACT
Choledocholithiasis is one of the more common benign disorders of the biliary tract with multiple features of presentation and several alternatives for its diagnosis and treatment. Our aim was to perform a based-evidence revision to propose a diagnostic and therapeutic algorithm. The raised values of gamma glutamiltranspeptidase, alkaline phosphatase and total bilirubin, are well predictors for a choledocholithiasis. The image evidence for a pre-operative detection with higher sensibility, specificity and better cost-effectiveness is the cholangioresonance. For its intraoperative detection, the cholangiography is the method most frequently used, though cholangioscopy is likewise useful. In the case of a post-operative suspicious, the cholangiography through the T tube is the gold standard. With regard to the treatment of the choledocholithiasis, the different stages are analyzed. depending if the detection was performed pre, intra or postoperatively. As a conclusion, the approach of the choledocholithiasis in one step seems to be better that to perform it in two steps, being the laparoscopic exploration for bile ducts stones more safety than the use of the intraoperative ERCP (endoscopic retrograde cholangiopancreatography) .The postoperative ERCP is not recommended excepting in very selected cases, and the biliodigestive derivations should be reserved only for the primary lithiasis of the common bile duc
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Ductos Biliares
/
Colangiografia
/
Cálculos da Bexiga Urinária
/
Colangiopancreatografia Retrógrada Endoscópica
/
Coledocolitíase
/
Síndrome de Mirizzi
Limite:
Humanos
Idioma:
Espanhol
Revista:
Prensa méd. argent
Assunto da revista:
Medicina
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Argentina
Instituição/País de afiliação:
Hospital Rivadavia/AR
/
Universidad de Buenos Aires/AR
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