Síndrome coledociano : complicaciones post-colangiopancreatografía retrógrada endoscópica
Fecha
2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
INTRODUCCION: En América Latina, se considera que entre un 5% y 15% de
la población presenta colelitiasis siendo Chile, Argentina y Ecuador los países
con mayor incidencia. Según datos del INEC – 2019, la colelitiasis es la primera
causa de morbilidad en el Ecuador con 43.673 egresos y la primera causa
morbilidad en las mujeres con 31.056 casos reportados. A nivel mundial, el
síndrome coledociano es la principal complicación de la colelitiasis y representa
un conjunto de características clínicas con ictericia, coluria y acolia o hipocolia
Objetivo: Determinar los eventos adversos de la colangiopancreatografía
retrograda endoscópica (CPRE) para definir la tasa de morbi-mortalidad de este
procedimiento. Metodología: observacional, descriptivo, propositivo, no
experimental, con modalidad de investigación cuantitativa con finalidad
bibliográfica, de campo y transversal y con método de análisis. Lugar y muestra:
hospital de especialidades Abel Gilbert Pontón con 140 pacientes con
enfermedad colestásica que se le realizaron CPRE como método terapéutica –
diagnostica. Resultado: se analizaron 140 CPRE`s donde un 51.5% fueron de
carácter terapéutico y con efectividad del 89%. Destaca que el género femenino
predispone la realización de CPRE con un 65.7% y con predominio en el grupo
etario entre los 30 y 49 años (20%) a comparación con el sexo masculino que
representa un 34.3%. El grado de incidencia de las complicaciones fue del 6%
por hemorragia, 25% por perforaciones, 49% para pancreatitis y 21% por
colangitis. Conclusiones: las manifestaciones clínicas y la impresión
diagnostica del paciente no constituyen un único factor predisponente para la
aparición de complicaciones y la tasa de mortalidad no se ve afectada por la
presencia de las complicaciones, lo que nos lleva a concluir que existe una
buena técnica quirúrgica para el manejo de enfermedades bilio pancreática.
INTRODUCTION: In Latin America, it is considered that between 5% and 15% of the population presents cholelithiasis, with Chile, Argentina and Ecuador being the countries with the highest incidence. According to data from INEC - 2019, cholelithiasis is the leading cause of morbidity in Ecuador with 43,673 discharges and the leading cause of morbidity in women with 31,056 reported cases. Worldwide, the choledochal syndrome is the main complication of cholelithiasis and represents a set of clinical characteristics with jaundice, choluria and acholia or hypocolia Objective: To determine the adverse events of endoscopic retrograde cholangiopancreatography (ERCP) to define the morbidity rate. mortality from this procedure. Methodology: observational, descriptive, purposeful, non-experimental, with a quantitative research modality with bibliographic, field and cross-sectional purposes and with an analysis method. Place and sample: Abel Gilbert Pontón specialty hospital with 140 patients with cholestatic disease who underwent ERCP as a therapeutic-diagnostic method. Result: 140 ERCPs were analyzed where 51.5% were therapeutic in nature and 89% effective. It is noteworthy that the female gender predisposes the performance of ERCP with 65.7% and with a predominance in the age group between 30 and 49 years (20%) compared to the male sex, which represents 34.3%. The incidence rate of complications was 6% for hemorrhage, 25% for perforations, 49% for pancreatitis, and 21% for cholangitis. Conclusions: the clinical manifestations and the diagnostic impression of the patient are not a single predisposing factor for the appearance of complications and the mortality rate is not affected by the presence of complications, which leads us to conclude that there is a good surgical technique for the management of biliary pancreatic diseases.
INTRODUCTION: In Latin America, it is considered that between 5% and 15% of the population presents cholelithiasis, with Chile, Argentina and Ecuador being the countries with the highest incidence. According to data from INEC - 2019, cholelithiasis is the leading cause of morbidity in Ecuador with 43,673 discharges and the leading cause of morbidity in women with 31,056 reported cases. Worldwide, the choledochal syndrome is the main complication of cholelithiasis and represents a set of clinical characteristics with jaundice, choluria and acholia or hypocolia Objective: To determine the adverse events of endoscopic retrograde cholangiopancreatography (ERCP) to define the morbidity rate. mortality from this procedure. Methodology: observational, descriptive, purposeful, non-experimental, with a quantitative research modality with bibliographic, field and cross-sectional purposes and with an analysis method. Place and sample: Abel Gilbert Pontón specialty hospital with 140 patients with cholestatic disease who underwent ERCP as a therapeutic-diagnostic method. Result: 140 ERCPs were analyzed where 51.5% were therapeutic in nature and 89% effective. It is noteworthy that the female gender predisposes the performance of ERCP with 65.7% and with a predominance in the age group between 30 and 49 years (20%) compared to the male sex, which represents 34.3%. The incidence rate of complications was 6% for hemorrhage, 25% for perforations, 49% for pancreatitis, and 21% for cholangitis. Conclusions: the clinical manifestations and the diagnostic impression of the patient are not a single predisposing factor for the appearance of complications and the mortality rate is not affected by the presence of complications, which leads us to conclude that there is a good surgical technique for the management of biliary pancreatic diseases.
Descripción
Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Palabras clave
COLELITIASIS, COLANGIOPANCREATOGRAFIA RETROGRADA ENDOSCOPICA, COMPLICACIONES, INDICADORES DE MORBIMORTALIDAD, EPIDEMIOLOGIA DESCRIPTIVA, HOSPITAL DE ESPECIALIDADES GUAYAQUIL DR. ABEL GILBERT PONTON, CANTON GUAYAQUIL, ECUADOR