lesiones de la vía biliar en colecistectomías laparoscópicas bile duct injures from laparoscopic cholecystectomy

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ID: 230883
2013
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Abstract
Introducción: en febrero de 1991, se realizó la primera colecistectomía laparoscópica en Cuba. No obstante sus beneficios, las lesiones de la vía biliar parecen ser más frecuentes. Objetivo: describir el comportamiento de las lesiones de la vía biliar en 6 centros de 5 provincias del país, a fin de detectar deficiencias al ser corregidas. Métodos: se realizó un estudio multicentros, descriptivo y retrospectivo de 27 lesiones de la vía biliar ocurridas en 17 288 colecistectomías laparoscópicas realizadas en 6 hospitales universitarios. Se colectó el dato primario a través de un cuestionario de 13 puntos, aplicado a cada paciente lesionado, y común para todos los centros. Resultados: el porcentaje de lesiones de la vía biliar en esta serie fue bajo (0,15 %). En 59,2 %, el diagnóstico fue posoperatorio y casi el 63 % fueron graves lesiones tipo E de Strasberg. Las técnicas de reparación más empleadas fueron las derivaciones biliodigestivas, pero las lesiones diagnosticadas durante el transoperatorio fueron en la mayoría de los casos tratados con reparación sobre sonda. Se presentaron complicaciones mayores en 25,9 %. Conclusiones: el porcentaje de lesiones en nuestro estudio es bajo, pero predominan las de carácter grave. Las estenosis posquirúrgicas, estuvieron predominantemente relacionadas con la elección errónea de la técnica primaria de reparación.
Introduction: On February 1991 the first laparoscopic cholecistectomy (LC) was performed in Cuba. Despite the benefits of this approach, bile ducts injuries (BDI) seem to be more frequent. Objective: To describe the behavior of the bile duct injuries in six hospitals located in 5 provinces throughout the country so as to detect deficiencies to be corrected. Methods: A retrospective, multicenter and descriptive study of 27 bile duct injuries on 17288 LC performed in 6 university hospitals throughout the country. The primary data was collected through a 13 point-questionnaire applied to every injured patient, and equal for all the centers. Results: The percentage of BDI in this series was low (0.15 %). In 59.2 % of cases, the diagnosis was made postoperatively and almost 63 % were severe Strasberg's type E lesions. The most used repair techniques were bile digestive derivations, but lesions identified transoperatively were in most of the cases treated with ''T'' tube repairs. Major complications occurred in 25.9 % of patients. Conclusions: The percentage of lesions in our study is low, but they were mostly severe. The postsurgical stenosis was mainly related with the wrong selection of the primary repair technique.
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santana2013revistalesiones Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Orlando Zamora Santana;José L Reguero Muñoz;Alberto Sánchez Menéndez;Alberto Garrido González;José M González Bárcena;Alfredo S Cabezas López
Journal chemistry and biodiversity
Year 2013
DOI
DOI not found
URL
http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932013000100005
Keywords
bile duct injuriessurgery

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