Colecistectomía convencional y laparoscópica en gestantes resultante obstétrica
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La colecistectomía es el segundo procedimiento quirúrgico no obstétrico practicado en gestantes. Las complicaciones son debatibles al compararlas con técnicas mínimamente invasivas. El objetivo central fue: Determinar la utilidad y seguridad de la colecistectomía laparoscópica frente a cirugía convencional en gestantes. Por el tipo y diseño de investigación se planteó un estudio: Analítico, correlacional, retrospectivo no experimental, de corte transversal. Se utilizó Chi Cuadrado de asociación considerándose significativo valores (p < 0.05). La población de estudio lo conformaron 40 casos de ellos 21 fueron con técnica abierta y 19 por laparoscopía. El tiempo de hospitalización promedio fue de (4 días) para técnica abierta y (3 días) para técnica laparoscópica. El tiempo quirúrgico fue de (134 minutos) para técnica abierta y (111 minutos) para laparoscópica, el uso de analgésico postcirugía laparoscópica fue de (2.32 días) y con técnica abierta (4.10 días). Con técnica abierta un (32.50 %) de las gestantes no presento complicaciones frente al (37.50 %) con laparoscopía. En cuanto a las complicaciones quirúrgicas el 40 % de las gestantes sometidas a colecistectomía abierta no presentaron complicaciones frente al (42.50 %), por laparoscopia. Razón por la cual se aceptó la hipótesis afirmativa que sustenta: La colecistectomía laparoscópica presenta similar utilidad y seguridad que la colecistectomía convencional, el (p valor) para complicaciones quirúrgicas fue de (0.003) para técnica abierta y (0.002) para laparoscopía. Mientras que el riesgo obstétrico arrojó un p valor de (0.021) con técnica abierta y (0.001) con laparoscópica respectivamente.
Cholecystectomy is the second non-obstetric surgical procedure performed in pregnant women. The complications are debatable when compared with minimally invasive techniques. The main objective was to determine the utility of conventional cholecystectomy versus laparoscopic surgery in pregnant women. For the type and design of research, a study was proposed: Correlational, retrospective non-experimental, cross-sectional. Chi Square association was used considering p <.005 values as significant. The study population consisted of 40 cases, 21 of them with open technique and 19 with laparoscopy. The average hospitalization time was (4 days) for open technique and (3 days) for laparoscopic technique. The surgical time was (134 minutes) for open technique and (111 minutes) for laparoscopy, the use of laparoscopic post-surgery analgesic was (2.32 days) and with open technique (4.10 days). With open technique, one (32.50%) of the pregnant women did not present complications compared to (37.50%) with laparoscopy. Regarding surgical complications, 40% of pregnant women undergoing open cholecystectomy had no complications compared to (42.50%), by laparoscopy. Reason for which accepted the affirmative hypothesis that sustains: Laparoscopic cholecystectomy has similar utility and safety than conventional cholecystectomy, the (p value) for surgical complications of .003 for open technique and .002 for laparoscopy. While the obstetric risk yielded a p value of .021 with open technique and .001 with laparoscopic respectively. Keywords:
Cholecystectomy is the second non-obstetric surgical procedure performed in pregnant women. The complications are debatable when compared with minimally invasive techniques. The main objective was to determine the utility of conventional cholecystectomy versus laparoscopic surgery in pregnant women. For the type and design of research, a study was proposed: Correlational, retrospective non-experimental, cross-sectional. Chi Square association was used considering p <.005 values as significant. The study population consisted of 40 cases, 21 of them with open technique and 19 with laparoscopy. The average hospitalization time was (4 days) for open technique and (3 days) for laparoscopic technique. The surgical time was (134 minutes) for open technique and (111 minutes) for laparoscopy, the use of laparoscopic post-surgery analgesic was (2.32 days) and with open technique (4.10 days). With open technique, one (32.50%) of the pregnant women did not present complications compared to (37.50%) with laparoscopy. Regarding surgical complications, 40% of pregnant women undergoing open cholecystectomy had no complications compared to (42.50%), by laparoscopy. Reason for which accepted the affirmative hypothesis that sustains: Laparoscopic cholecystectomy has similar utility and safety than conventional cholecystectomy, the (p value) for surgical complications of .003 for open technique and .002 for laparoscopy. While the obstetric risk yielded a p value of .021 with open technique and .001 with laparoscopic respectively. Keywords:
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Colecistectomía laparoscópica, Enfermedades de las vías biliares, Mujeres embarazadas, Complicaciones, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador, Colecistectomía convencional