Empleo del modelo animal en la formación enendoscopia diagnóstica y terapéutica de la vía biliar / Animal model training in diagnostic and therapeutic biliary tract endoscopy teaching

Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compañeros. Conclusiones. El empleo del modelo animal en la formación en colangio pancreatografía retrógada endoscópica (CPRE)permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases (AU)

Aim. To show our experience in training in therapeutic endoscopy of the biliary tract in animal model. Materials and methods. This training activity has duration of 13 hours and starts initiating the trainee in anatomical differences with regard to human anatomy that occur between species that are used, the swine and canine. The practices consist of endoscopist to habituate the lateral view of duodenoscope, performing on pig model because it is easier to pass through the pyloricsphincter, although this is not very suitable for cannulation of the duodenal papilla. After passing the first stage, we used the canine model to acquire the skills and abilities specific to this technique. The performance evaluation is done through an anonymous survey. Results. 76% of students confirmed that they have made good progress with this training, 18% regular and 6% that shortly. 75% believed that after making this training would be found competent to carry out the technique in their hospitals. About 94% of students would recommend this activity. Conclusions. The use of animal model in training in endoscopic retrograde cholangiopancreatography (ERCP)permits the acquisition of basic skills needed for practice, a sit enables the repetition of the maneuvers and continuing care. We believe that this mixed methodology could shorten the learning curve for ERCP and reduce iatrogenic in the early stages (AU)

[The value of diagnostic endoscopy in the treatment of intestinal polyps in the child]. / Valor de la endoscopia en el diagnóstico y tratamiento de los pólipos del tracto intestinal en el niño.

The polyps of the digestive tract, with the exception of the juvenile ones, are not often found in children. Out of 762 endoscopies paediatric patients carried out, 31 were seen to be affected by digestive polyps, of which 16 were juvenile. The rest belonged to other types, among which 5 adenomas are included. In this paper, clinical aspects are analysed, pointing out also the value of the endoscopy as choice method not only for diagnosis but also for treatment of polyps.

[Adenomatous degeneration in a prepuberal patient with generalized juvenile polyposis and angiomas of the oral mucosa]. / Degeneración adenomatosa en una paciente prepuberal afecta de poliposis juvenil generalizada y angiomas en mucosa oral.

The authors present a 12 year old patient affected by a juvenile polyposis syndrome. They describe the clinic and the complementary tests carried out, especially the findings of the digestive fibroendoscopy which allowed multiple polyps in the duodenum, colon and rectum to be shown, confirmed by an anatomopathological study. Two years afterwards, a total colectomy and ileoproctostomy was carried out. In the operative piece included numerous hamartomatous polyps with adenomatous isolated foci. A subsequent endoscopic exploration showed numerous polyps in anus and rectal stump. The adenomatous transformation and recidivation of her polyposis require close vigilance and a follow-up of this female patient in view of the possibility of the precocious development of a colorectal carcinoma.