Entrenamiento en Cirugía Bariátrica. Importancia de las Carreras de posgrado Universitarias / Training in bariatric surgery: Importance of University Postgraduate Careers

Bariatric surgery is performed usually in a videolaparoscopic form. This involves that surgeons must have the abilities of advanced laparascopy. The learning curve was previously analyzed in numerous reports. This curriculums for the fellowships include the development of cognitive abilities and clinicotechnical training. Through the Course of Specialists for Metabolic and Bariatric Surgery from the Buenos Aires University, four fellows have been formed. In this study, the training modality is described

La cirugía bariátrica se realiza generalmente de forma videolaparoscópica. Esto implica que los cirujanos tengan habilidades de laparoscopía avanzada. La curva de aprendizaje se ha analizado en numerosos trabajos. Las currículas para los fellowship incluyen el desarrollo de habilidades cognitivas y clínico-técnicas. A través de la Carrera de Especialista en Cirugía Bariátrica y Metabólica de la UBA se han formado cuatro fellows. En este trabajo se describe la modalidad de aprendizaje

Management of gallstones and gallbladder disease in patients undergoing gastric bypass.

The appropriate management of gallstones and gallbladder disease in patients undergoing gastric bypass remains unknown. Several therapeutic modalities are used and include performing cholecystectomy on all patients at the time of gastric bypass, performing concomitant cholecystectomy only when patients have gallstones and performing cholecystectomy only in the presence of both symptoms and gallstones. Some groups administer ursodeoxycholic acid for gallstone prevention in the postoperative period. All treatment modalities are analyzed and their results and rationality are discussed.

[Single-stage management of common duct stones by video-assisted laparoscopy. Analysis of 10 years' experience]. / Tratamiento de la coledocolitiasis en un tiempo por videolaparoscopia. Análisis de 10 años de experiencia.

INTRODUCTION: The management of patients with gallstone disease and ductal calculi is controversial. The main options are one-stage or two-stage management. MATERIAL AND METHOD: We performed a retrospective analysis of the experience gained over 10 years in the one-stage management of common duct stones in a high-volume tertiary hospital. RESULTS: A total of 569 patients were initially treated by laparoscopy. Of these, 412 (76.3%) underwent the transcystic approach, 128 (23.7%) underwent laparoscopic choledochotomy and 29 (5%) were converted to open surgery. Overall morbidity and mortality were 2.46% and 0.52%, respectively. CONCLUSIONS: In high-volume centers, one-stage laparoscopic management of common duct stones is safe and feasible, with a high proportion of patients that only require a transcystic approach.

Tratamiento de la coledocolitiasis en un tiempo por videolaparoscopia. Análisis de 10 años de experiencia / Single-stage management of common duct stones by video-assisted laparoscopy. Analysis of 10 years’ experience

Introducción. El manejo de los pacientes con litiasis vesicular y coledociana plantea controversias. El tratamiento en uno o en dos tiempos son las principales opciones. Material y método. Análisis retrospectivo de la experiencia de 10 años en el tratamiento en un tiempo de la coledocolitiasis en un centro terciario de alto volumen. Resultados. Se trató inicialmente por laparoscopia a 569 pacientes; se resolvieron con un abordaje transcístico 412 (76,3%); mediante coledocotomía laparoscópica, 128 (23,7%) y se convertió a cirugía abierta a 29 (5%). La morbilidad y la mortalidad general fueron del 2,46 y el 0,52%, respectivamente. Conclusiones. En centros de alto volumen el tratamiento en un tiempo y por laparoscopia de la coledocolitiasis es factible y seguro, con una alta proporción de pacientes que sólo necesitan de un abordaje transcístico (AU)

Introduction. The management of patients with gallstone disease and ductal calculi is controversial. The main options are one-stage or two-stage management. Material and method. We performed a retrospective analysis of the experience gained over 10 years in the one-stage management of common duct stones in a high-volume tertiary hospital. Results. A total of 569 patients were initially treated by laparoscopy. Of these, 412 (76.3%) underwent the transcystic approach, 128 (23.7%) underwent laparoscopic choledochotomy and 29 (5%) were converted to open surgery. Overall morbidity and mortality were 2.46% and 0.52%, respectively. Conclusions. In high-volume centers, one-stage laparoscopic management of common duct stones is safe and feasible, with a high proportion of patients that only require a transcystic approach (AU)