Utilidad diagnóstica de punción guiada por ecoendoscopía frente a tomografía contrastada de lesiones sólidas del páncreas
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Las lesiones sólidas del páncreas corresponde a un grupo de patologías de naturaleza potencialmente maligna con incidencia a partir de los treinta años . Su abordaje parte del estudio punción histológica, bien mediante ecoendoscopia o tomografía. La investigación tiene por objetivo determinar la utilidad diagnóstica de la punción por ecoecondoscopia frente a punción dirigida por tomografía en lesiones sólidas del páncreas de pacientes atendidos en el servicio de Gastroenterología del Hospiatl Dr. Juan Tanca Marengo (SOLCA) durante el periodo comprendido entre enero 2017 y junio 2018 El trabajo utilizó como metodología el estudio observacional, analítico, de cohorte histórico. Durante el periodo de estudio se identifico 103 casos con lesiones pancreáticas, de las cuales 40 cumplieron los criterios de selección. De estos 29/40 (72.5%) correspondieron a casos en donde la biopsia fue dirigida mediante ultrasonido endoscópico y 11/40 (27.5%) mediante tomografía computarizada. La mediana de edad de la población fue de 67 (38-88) años 20/40 (50%) mujeres. La mediana del diámetro de las lesiones abordadas mediante ecoendoscopia fue significativamente menor en comparación para con aquellas abordadas mediante tomografía (32 mm vs 60mm; p=0.019) los principales hallazgos patológicos obtenidos mediante punción histológica ecoendoscopía poseen mayor suficiencia diagnóstica para con malignidad ante lesiones pancreáticas sólida ¿s, en contraposición a la punción histológica guiada por tomografía computada la comparación de estas dos técnicas diagnósticas en lesiones solidas del páncreas permitió evaluar la eficacia de la punción guiada por ecoendoscopia, intentado ubicarla como la prueba estándar para diagnóstico de dichas lesiones.
The solid lesions of the pancreas correspond to a group of pathologies of a potentially malignant nature with an incidence from the age of thirty. Its approach starts from the histological puncture study, either by echoendoscopy or tomography. The objective of the research is to determine the diagnostic utility of the puncture by ecoecondoscopy versus puncture directed by tomography in solid lesions of the pancreas of patients treated in the Gastroenterology department of the Dr. Juan Tanca Marengo Hospital (SOLCA) during the period between January 2017 and June 2018 The work used the observational, analytical, historical cohort study as a methodology. During the study period, 103 cases with pancreatic lesions were identified, of which 40 met the selection criteria. Of these 29/40 (72.5%) corresponded to cases in which the biopsy was directed by endoscopic ultrasound and 11/40 (27.5%) by computed tomography. The median age of the population was 67 (38-88) years 20/40 (50%) women. The median diameter of the lesions addressed by echoendoscopy was significantly smaller compared to those addressed by tomography (32 mm vs 60mm; p = 0.019). The main pathological findings obtained by histological puncture echoendoscopy have a higher diagnostic sufficiency for malignancy before pancreatic lesions. In contrast to the histological puncture guided by computed tomography, the comparison of these two diagnostic techniques in solid lesions of the pancreas allowed to evaluate the efficacy of the puncture guided by echoendoscopy, trying to locate it as the standard test for diagnosis of said lesions.
The solid lesions of the pancreas correspond to a group of pathologies of a potentially malignant nature with an incidence from the age of thirty. Its approach starts from the histological puncture study, either by echoendoscopy or tomography. The objective of the research is to determine the diagnostic utility of the puncture by ecoecondoscopy versus puncture directed by tomography in solid lesions of the pancreas of patients treated in the Gastroenterology department of the Dr. Juan Tanca Marengo Hospital (SOLCA) during the period between January 2017 and June 2018 The work used the observational, analytical, historical cohort study as a methodology. During the study period, 103 cases with pancreatic lesions were identified, of which 40 met the selection criteria. Of these 29/40 (72.5%) corresponded to cases in which the biopsy was directed by endoscopic ultrasound and 11/40 (27.5%) by computed tomography. The median age of the population was 67 (38-88) years 20/40 (50%) women. The median diameter of the lesions addressed by echoendoscopy was significantly smaller compared to those addressed by tomography (32 mm vs 60mm; p = 0.019). The main pathological findings obtained by histological puncture echoendoscopy have a higher diagnostic sufficiency for malignancy before pancreatic lesions. In contrast to the histological puncture guided by computed tomography, the comparison of these two diagnostic techniques in solid lesions of the pancreas allowed to evaluate the efficacy of the puncture guided by echoendoscopy, trying to locate it as the standard test for diagnosis of said lesions.
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Lesiones sólidas del páncreas, Endosonografía, Tomografía, Gastroenterología, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador