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Vol. 71. Núm. 6.
Páginas 314-318 (junio 2002)
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Vol. 71. Núm. 6.
Páginas 314-318 (junio 2002)
Acceso a texto completo
Coledocolitiasis: indicaciones de colangiopancreatografía retrógrada endoscópica y colangiorresonancia magnética
Choledocholithiasis: Indications for endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography
Visitas
37143
Camilo J. Castellón1
Autor para correspondencia
ccastellonp@teleline.es

Correspondencia: Dr. C.J. Castellón Pavón. Bioy Casares, 1, esc. 1, 2,º D. 10005 Cáceres.
, Elías Del Amo
Servicio de Cirugía General
Miguel Fernándeza
a Unidad de Medicina Digestiva. Hospital San Pedro de Alcántara. Cáceres
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Resumen

El tratamiento de los pacientes con coledocolitiasis es controvertido. El desarrollo de nuevas tecnologías (colangiorresonancia magnética, tomografía axial computarizada [TAC] helicoidal con colangiograma, ecografía endoscópica) ha permitido lograr un diagnóstico más exacto de la coledocolitiasis, modificar el abordaje quirúrgico inicial en centros sin suficiente experiencia laparoscópica y evitar exploraciones preoperatorias innecesarias, con la consiguiente reducción de complicaciones. Aunque se han propuesto diversas estrategias diagnosticoterapéuticas que permiten un empleo más racional de los distintos recursos, no existe consenso sobre los criterios de selección.

Revisamos las indicaciones actuales de la colangiopancreatografía retrógrada endoscópica y la colangiorresonancia magnética y proponemos un algoritmo diagnóstico basado en el grado de sospecha de coledocolitiasis.

Palabras clave:
Coledocolitiasis
Colangiopancreatografía retrógrada endoscópica
Colangiorresonancia magnética

The management of patients with common bile duct stones remains controversial. New developments in diagnostic modalities (magnetic resonance cholangiography, helical computed tomography cholangiography and endoscopic ultrasonography) have allowed us to achieve an accurate diagnosis of choledocholithiasis and to modify the initial surgical approach in centers without sufficient experience in laparoscopy, with a consequent reduction of complications.

Although many diagnostic and therapeutic strategies have been proposed to achieve a more rational use of resources and improve patient care, consensus on selection criteria is lacking.

We review the current indications for endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography, and propose a diagnostic algorithm based on risk for choledocholithiasis.

Key words:
Choledocholithiasis
Endoscopic retrograde cholangiopancreatography
Magnetic resonance cholangiography
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Bibliografía
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Copyright © 2002. Asociación Española de Cirujanos
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