Validez del uso de endoprótesis de la vía biliar en el manejo paliativo de la ictericia obstructiva en tumores malignos biliopancreáticos
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: La colocación de endoprótesis biliares por vía endoscópica es una opción terapéutica en estadios avanzados, como medida paliativa de la ictericia obstructiva. Objetivo: Evidenciar la validez del uso de endoprótesis de la vía biliar en el manejo paliativo de la ictericia obstructiva en tumores malignos bilioprancreaticos. Materiales y Métodos: muestra de 143 historias clínicas de pacientes con diagnóstico de obstrucción de la vía biliar por tumores biliopancreáticos, con prótesis endobiliar mediante CPRE. Metodología: Se utilizaron tablas de frecuencia y estadísticos descriptivos de tendencia central y medidas de dispersión. Se aplicaron pruebas de t de student y ANOVA para establecer diferencias en los niveles de bilirrubina total y en la escala ECOG de la calidad de vida antes y después de la colocación del stent. Resultados: Mayor presencia en hombres (56,8 %) que en mujeres (43,2%), la edad más frecuente es de 65 años (58,9%). Los tumores más frecuentes fueron el colangiocarcinoma (42%) de tumores de la ampolla de Váter (29,4%) y páncreas (28,7%). Los parámetros de bilirrubina pasaron de 2,19 antes del stent a 1,5 después del stent con diferencia significativa (0,000). Las complicaciones que presentaron tanto tempranas y fueron de menos del 15,8% acumulado. ECOG determinó una mejoría en la calidad de vida posterior a la colocación del stent, pasando de un promedio de 3,21 puntos antes del stent a 2,48 puntos luego del stent. Conclusiones: se corrobora que la colocación de la endoprótesis biliar mejora significativamente la calidad de vida de los pacientes con ictericia obstructiva.
Palabras clave: ictericia, tumores biliopancreáticos, estenosis biliar, stent biliar, calidad de vida
Background: Endoscopic placement of biliary stents is a therapeutic option in advanced stages, as a palliative measure for obstructive jaundice. Objective: To demonstrate the validity of the use of bile duct endoprostheses in the palliative management of obstructive jaundice in malignant biliopancreatic tumors. Materials and Methods: sample of 143 clinics of patients with diagnostic histories of bile duct obstruction due to biliopancreatic tumors, with endobiliary prosthesis by ERCP. Methodology: Frequency tables and descriptive statistics of central tendency and dispersion measures were used. Student's t-test and ANOVA were applied to establish differences in total bilirubin levels and in the ECOG scale of quality of life before and after stent placement. Results: Greater presence in men (56.8%) than in women (43.2%), the most frequent age is 65 years (58.9%). The most frequent tumors were cholangiocarcinoma (42%), tumors of the ampulla of Vater (29.4%) and pancreas (28.7%). Bilirubin parameters went from 2.19 before the stent to 1.5 after the stent, with a significant difference (0.000). The complications that appeared both early and were less than 15.8% accumulated. ECOG reported an improvement in quality of life after stent placement, going from an average of 3.21 points before stent placement to 2.48 points after stent placement. Conclusions: it is corroborated that the placement of the biliary stent significantly improves the quality of life of patients with obstructive jaundice. Keywords: jaundice, biliopancreatic tumors, biliary stenosis, biliary stent, quality of life
Background: Endoscopic placement of biliary stents is a therapeutic option in advanced stages, as a palliative measure for obstructive jaundice. Objective: To demonstrate the validity of the use of bile duct endoprostheses in the palliative management of obstructive jaundice in malignant biliopancreatic tumors. Materials and Methods: sample of 143 clinics of patients with diagnostic histories of bile duct obstruction due to biliopancreatic tumors, with endobiliary prosthesis by ERCP. Methodology: Frequency tables and descriptive statistics of central tendency and dispersion measures were used. Student's t-test and ANOVA were applied to establish differences in total bilirubin levels and in the ECOG scale of quality of life before and after stent placement. Results: Greater presence in men (56.8%) than in women (43.2%), the most frequent age is 65 years (58.9%). The most frequent tumors were cholangiocarcinoma (42%), tumors of the ampulla of Vater (29.4%) and pancreas (28.7%). Bilirubin parameters went from 2.19 before the stent to 1.5 after the stent, with a significant difference (0.000). The complications that appeared both early and were less than 15.8% accumulated. ECOG reported an improvement in quality of life after stent placement, going from an average of 3.21 points before stent placement to 2.48 points after stent placement. Conclusions: it is corroborated that the placement of the biliary stent significantly improves the quality of life of patients with obstructive jaundice. Keywords: jaundice, biliopancreatic tumors, biliary stenosis, biliary stent, quality of life
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Neoplasias de los conductos biliares, Estenosis biliar, Calidad de vida, Ictericia obstructiva, Indicadores (estadística), Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador