Colecistectomía abierta y sus complicaciones post-quirúrgicas en pacientes con colecistitis aguda
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La colecistitis aguda se acompaña de cálculos biliares, su origen es la obstrucción
del cístico debido a un cálculo o a la compresión extrínseca por el cuello vesicular
secundario a un cálculo impactado. Dicha obstrucción provoca distensión de la vesícula
y contracción del musculo de la pared en respuesta a la oclusión. Si persiste se
incrementa la presión intravesicular, disminuye el flujo del retorno venoso, provocando
isquemia y necrosis de la pared de la vesícula que puede terminar en perforación la
proliferación bacteriana que contamina la bilis se asocia a este proceso inflamatorio, se
presenta dolor pungitivo constante y progresivo localizado en el hipocondrio izquierdo
o zona precordial, que se puede irradiar a hombro, zona escapular derecha, nauseas,
vómitos, fiebre e ictericia. Su diagnóstico se basa en hallazgos clínicos y se confirma
por ecografía, su tratamiento es quirúrgico. En la presente investigación se emplearon
métodos: cuantitativo y cualitivo, no experimental de corte retrospectivo y teórico,
analítico, observacional y correlacional. El universo estuvo conformado por 150
pacientes y la muestra de 125 pacientes como grupo focal a investigar. De acuerdo a
los datos estadísticos dio como resultado una mayor incidencia en el sexo femenino un
74 % (93 mujeres), masculino un 26% (32 hombres). Esta investigación se la planteo
para determinar las complicaciones post quirúrgicas de la colecistectomía abierta en
HGGS en un tiempo comprendido desde el mes de mayo 2017 hasta mayo 2018. Esta
investigación servirá como apoyo para las futuras promociones de estudiantes en la
rama de la medicina.
Acute cholecystitis is accompanied by gallstones, its origin is cystic obstruction due to a calculus or extrinsic compression by the vesicular neck secondary to an impacted calculus. This obstruction causes distention of the gallbladder and contraction of the wall muscle in response to the occlusion. If it persists, the intravesicular pressure increases, the venous return flow decreases, causing ischemia and necrosis of the gallbladder wall that can end up perforating the bacterial proliferation that contaminates the bile is associated with this inflammatory process, constant pungitive pain is present and Progressive located in the left hypochondrium or precordial area, which can radiate to the shoulder, right scapular area, nausea, vomiting, fever and jaundice. Its diagnosis is based on clinical findings and is confirmed by ultrasound, its treatment is surgical. In the present investigation, methods were used: quantitative and qualitative, not experimental, retrospective and theoretical, analytical, observational and correlational. The universe consisted of 150 patients and the sample of 125 patients as a focus group to investigate. According to statistical data, 74% (93 women) and 26% men (32 men) were more likely to be women. This research was proposed to determine post-surgical complications of open cholecystectomy in HGGS from May 2017 to May 2018. This research will serve as support for future promotions of students in the field of medicine.
Acute cholecystitis is accompanied by gallstones, its origin is cystic obstruction due to a calculus or extrinsic compression by the vesicular neck secondary to an impacted calculus. This obstruction causes distention of the gallbladder and contraction of the wall muscle in response to the occlusion. If it persists, the intravesicular pressure increases, the venous return flow decreases, causing ischemia and necrosis of the gallbladder wall that can end up perforating the bacterial proliferation that contaminates the bile is associated with this inflammatory process, constant pungitive pain is present and Progressive located in the left hypochondrium or precordial area, which can radiate to the shoulder, right scapular area, nausea, vomiting, fever and jaundice. Its diagnosis is based on clinical findings and is confirmed by ultrasound, its treatment is surgical. In the present investigation, methods were used: quantitative and qualitative, not experimental, retrospective and theoretical, analytical, observational and correlational. The universe consisted of 150 patients and the sample of 125 patients as a focus group to investigate. According to statistical data, 74% (93 women) and 26% men (32 men) were more likely to be women. This research was proposed to determine post-surgical complications of open cholecystectomy in HGGS from May 2017 to May 2018. This research will serve as support for future promotions of students in the field of medicine.
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Colecistectomía, Colecistitis, Complicaciones posoperatorias, Epidemiología descriptiva, Estudios retrospectivos, Hospital General Guasmo Sur, Cantón Guayaquil, Ecuador