Tratamiento precoz con colangiopancreatografía retrograda endoscópica (CPRE) y reducción de la mortalidad en pacientes con colangitis aguda
No hay miniatura disponible
Fecha
2022
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: La colangitis aguda es una enfermedad infecciosa del sistema biliar y potencialmente puede causar una morbilidad y mortalidad significativas. El papel de la colangiopancreatografía retrograda endoscópica en el manejo de esta patología se ha aceptado universalmente como tratamiento de primera línea durante las últimas 2 décadas con una disminución de la mortalidad. Es importante examinar la práctica actual de este procedimiento en la era moderna y su influencia en la reducción de la mortalidad. Objetivo: Analizar el tratamiento precoz con colangiopancreatografía retrograda endoscópica y reducción de la mortalidad en pacientes con colangitis aguda. Metodología: Estudio de caso control, de nivel relacional en el que se incluyó 100 pacientes consecutivos, no aleatorios atendidos en el hospital Teodoro Maldonado Carbo en Guayaquil, Ecuador, entre 1-01-2017 al 31-12-2019. Las pruebas utilizadas fueron el chi-cuadrado de homogeneidad y el t de Student Fisher para muestras independientes. Se empleará el software SPSS versión 28 y considerándose significativos un p < 0.05 Resultados: Entre la CPRE precoz y la tardía no se evidenció diferencia estadísticamente en relación con tiempo de intervención (32 ± 5 vs 30 ± 5 minutos; p 0.154), estancia hospitalaria (10 ± 8 vs 10 ± 8 días; p 0.782), complicaciones (26% vs 28%; p 0.822), complicación transquirúrgica (4% vs 6% p 0.500), complicaciones postquirúrgicas (26% vs 28%, p 0.822) y mortalidad (2% vs 4%, p 0.500). Conclusión: El CPRE precoz no reduce significativamente la tasa de mortalidad en pacientes con colangitis aguda, aunque existe una tendencia a reducirla.
Background: Acute cholangitis is an infectious disease of the biliary system and can potentially cause significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography in the management of this pathology has been universally accepted as first-line treatment during the last 2 decades with a decrease in mortality. It is important to examine the current practice of this procedure in the modern era and its influence on mortality reduction. Objective: To analyze early treatment with endoscopic retrograde cholangiopancreatography and mortality reduction in patients with acute cholangitis. Methodology: Relational level case control study that included 100 consecutive, non-randomized patients treated at the Teodoro Maldonado Carbo hospital in Guayaquil, Ecuador, between 01-01-2017 to 12-31-2019. The tests used were the chi-square test for homogeneity and Student Fisher's t-test for independent samples. SPSS version 28 software will be used and p < 0.05 is considered significant. Results: There was no statistical difference between early and late ERCP in relation to intervention time (32 ± 5 vs 30 ± 5 minutes; p 0.154), hospital stay (10 ± 8 vs 10 ± 8 days; p 0.782), complications (26% vs 28%; p 0.822), trans-surgical complication (4% vs 6% p 0.500), post-surgical complications (26% vs 28%, p 0.822) and mortality (2% vs 4%, p 0.500). Conclusion: Early ERCP does not significantly reduce the mortality rate in patients with acute cholangitis, although there is a tendency to reduce it.
Background: Acute cholangitis is an infectious disease of the biliary system and can potentially cause significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography in the management of this pathology has been universally accepted as first-line treatment during the last 2 decades with a decrease in mortality. It is important to examine the current practice of this procedure in the modern era and its influence on mortality reduction. Objective: To analyze early treatment with endoscopic retrograde cholangiopancreatography and mortality reduction in patients with acute cholangitis. Methodology: Relational level case control study that included 100 consecutive, non-randomized patients treated at the Teodoro Maldonado Carbo hospital in Guayaquil, Ecuador, between 01-01-2017 to 12-31-2019. The tests used were the chi-square test for homogeneity and Student Fisher's t-test for independent samples. SPSS version 28 software will be used and p < 0.05 is considered significant. Results: There was no statistical difference between early and late ERCP in relation to intervention time (32 ± 5 vs 30 ± 5 minutes; p 0.154), hospital stay (10 ± 8 vs 10 ± 8 days; p 0.782), complications (26% vs 28%; p 0.822), trans-surgical complication (4% vs 6% p 0.500), post-surgical complications (26% vs 28%, p 0.822) and mortality (2% vs 4%, p 0.500). Conclusion: Early ERCP does not significantly reduce the mortality rate in patients with acute cholangitis, although there is a tendency to reduce it.
Descripción
PDF
Palabras clave
Morbimortalidad, Estudio de casos, Postquirúrgicas, Hospital de Especialidades Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador