Prevalencia de colelitiasis en pacientes con cirrosis hepática en el período de junio del 2012 a junio del 2014 en el Hospital Teodoro Maldonado Carbo
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Fecha
2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
Las enfermedades hepáticas y biliares son patologías muy frecuentes en nuestro país, por
ello el objetivo de este estudio fue determinar la prevalencia de colelitiasis en pacientes
con cirrosis hepática.
La litiasis vesicular es una patología común en nuestro país de etiología multifactorial y
que sigue un curso benigno y con una baja morbi-mortalidad post colecistectomía y
mucho más si es por vía laparoscópica, sin embargo la colelitiasis asociada a la cirrosis
hepática es de pronóstico reservado, ya que la morbi-mortalidad es mucho mayor.
La prevalencia de colelitiasis en pacientes cirróticos es mayor que en la población
general, sin embargo las complicaciones de la colelitiasis ocurren menos frecuentemente
en cirróticos que en no cirróticos, pero las secundarias a la colecistectomía si son mayores
en cirróticos, representando la causa de muerte en 27,2% en comparación con 14,0% en
los no cirróticos. Esto nos orienta a realizar un manejo conservador ante una colelitiasis
silente no complicada en pacientes cirróticos.
La etiología de la hepatopatía se establece mediante la historia clínica, inmunología
(HBsAg, autoanticuerpos) y características microscópicas de la biopsia. Dentro de la
etiología más frecuente de la cirrosis en pacientes que desarrollan colelitiasis es la
alcohólica, seguida de la etiología postviral, esto en países latinoamericanos
principalmente como el nuestro, en cuanto al diagnóstico, los métodos por imágenes
constituye un método de elección, ya que los pacientes cirróticos que desarrollan
colelitiasis en su mayor parte permanecen silentes, es decir son asintomáticos. En cuanto
al tipo de litos mayormente encontrados en pacientes cirróticos son los de tipo
pigmentario.
Con el objetivo de precisar la frecuencia de colelitiasis en nuestros pacientes cirróticos,
así como, sus principales variables clínico-epidemiológicas y su asociación con la
severidad de la disfunción hepática, decidimos efectuar el presente estudio investigativo.
Liver and biliary diseases are very common diseases in our country, so the aim of this study was to determine the prevalence of cholelithiasis in patients with liver cirrosis. The stones in the gallbladder is one of the most important issues affecting health and old man; with serious medical, social and economic implications, its high frequency and complications. It is a chronic disease that is among the most common gastrointestinal. Cholelithiasis is a disease that affects millions of people worldwide, especially in Western societies, where it is diagnosed between 10% and 30% of its inhabitants and every year there are a million new cases. It occurs in 20% of women and 10% of men The cholelithiasis is a common disease in our country of multifactorial etiology and follows a benign course with a low morbidity and mortality post cholecystectomy and much more if laparoscopically, however cholelithiasis associated with liver cirrhosis prognosis is reserved as the morbidity and mortality is much higher. Cholelithiasis prevalence is higher in cirrhotic patients than in the general population, however complications of cholelithiasis in cirrhotic occur less frequently than noncirrhotic, but if secondary cholecystectomy are higher in cirrhotic, representing the cause of death in 27.2% compared with 14.0% in non-cirrhotic. This leads us to make a conservative approach to uncomplicated silent cholelithiasis in cirrhotic patients. The etiology of liver disease is established by medical history, immunology (HBsAg, autoantibodies) and microscopic characteristics of the biopsy. Among the most common cause of cirrhosis in patients who develop cholelithiasis is alcohol, followed by post-viral etiology, that mainly in Latin American countries like ours, in terms of diagnosis, imaging methods is a method of choice because cirrhotic patients who develop gallstones remain mostly silent, ie are asymptomatic. As for the type of calculi mostly found in cirrhotic patients are the type of pigment. In order to clarify the frequency of cholelithiasis in our cirrhotic patients and its main clinical and epidemiological variables and their association with the severity of liver dysfunction, we decided to conduct this research study.
Liver and biliary diseases are very common diseases in our country, so the aim of this study was to determine the prevalence of cholelithiasis in patients with liver cirrosis. The stones in the gallbladder is one of the most important issues affecting health and old man; with serious medical, social and economic implications, its high frequency and complications. It is a chronic disease that is among the most common gastrointestinal. Cholelithiasis is a disease that affects millions of people worldwide, especially in Western societies, where it is diagnosed between 10% and 30% of its inhabitants and every year there are a million new cases. It occurs in 20% of women and 10% of men The cholelithiasis is a common disease in our country of multifactorial etiology and follows a benign course with a low morbidity and mortality post cholecystectomy and much more if laparoscopically, however cholelithiasis associated with liver cirrhosis prognosis is reserved as the morbidity and mortality is much higher. Cholelithiasis prevalence is higher in cirrhotic patients than in the general population, however complications of cholelithiasis in cirrhotic occur less frequently than noncirrhotic, but if secondary cholecystectomy are higher in cirrhotic, representing the cause of death in 27.2% compared with 14.0% in non-cirrhotic. This leads us to make a conservative approach to uncomplicated silent cholelithiasis in cirrhotic patients. The etiology of liver disease is established by medical history, immunology (HBsAg, autoantibodies) and microscopic characteristics of the biopsy. Among the most common cause of cirrhosis in patients who develop cholelithiasis is alcohol, followed by post-viral etiology, that mainly in Latin American countries like ours, in terms of diagnosis, imaging methods is a method of choice because cirrhotic patients who develop gallstones remain mostly silent, ie are asymptomatic. As for the type of calculi mostly found in cirrhotic patients are the type of pigment. In order to clarify the frequency of cholelithiasis in our cirrhotic patients and its main clinical and epidemiological variables and their association with the severity of liver dysfunction, we decided to conduct this research study.
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Colelitiasis, Cirrosis hepática, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Prevalencia