Estadísticas

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  "cita" => "Cir Esp. 1998;63:258-63"
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      "titulo" => "El síndrome de la vena cava superior como urgencia oncológica. Tratamiento con prótesis de Gore-tex"
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          "titulo" => "Bile duct injury following open and laparoscopic surgery"
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    "cita" => "Cir Esp. 1998;63:254-6"
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      "titulo" => "Pancreatitis aguda de repetición secundaria a un seudotumor duodenal por páncreas heterotópico"
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          "titulo" => "Gastrointestinal anastomoses using biofragmentable rings sealed with fibrin glue"
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          "autoresLista" => "JA Guerrero, OI Morales, JL Tovar, N Muñoz, E Segovia, R Vara-Thorbeck, M Ruiz Morales, J Rosell"
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    "titulo" => "Lesiones iatrogénicas de la vía biliar principal tras colecistectomía abierta. Experiencia personal"
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        "titulo" => "Iatrogenic injury of the common bile duct after open cholecystectomy. Our personal experience"
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        "resumen" => "<span class="elsevierStyleBold">Introducci&#243;n&#46;</span> La incidencia de lesiones quir&#250;rgicas de la v&#237;a biliar durante la colecistectom&#237;a abierta oscila entre el 0&#44;2 y el 0&#44;5&#37;&#46; <br/> <span class="elsevierStyleBold"><span class="elsevierStyleBold">Pacientes y M&#233;todos&#46;</span></span> Se realiza un an&#225;lisis retrospectivo de las lesiones iatrog&#233;nicas de la v&#237;a biliar en 1&#46;697 colecistectom&#237;as abiertas realizadas en nuestro servicio&#44; desde enero de 1986 hasta diciembre de 1995&#46; <br/> <span class="elsevierStyleBold">Resultados&#46;</span> Se identificaron 11 lesiones quir&#250;rgicas de la v&#237;a biliar&#58; 3 secciones completas de col&#233;doco&#44; 2 lesiones parciales de los hep&#225;ticos&#44; dos en el col&#233;doco&#44; una desinserci&#243;n del c&#237;stico&#44; una ligadura de col&#233;doco y 2 estenosis de v&#237;as biliares&#46; En 7 pacientes el diagn&#243;stico es intraoperatorio&#44; en dos durante la primera semana y en otros dos a los 12 y 14 meses&#46; El tratamiento quir&#250;rgico realizado fue anastomosis t&#233;rmino-terminal en 2 casos&#44; hepaticoyeyunostom&#237;a en tres&#44; sutura simple en cuatro&#44; sutura m&#225;s drenaje de Kehr en uno y secci&#243;n de la ligadura en uno&#46; La mayor&#237;a de las lesiones &#40;80&#37;&#41; se produjeron durante la colecistectom&#237;a por colecistitis aguda &#40;p &#60; 0&#44;005&#41;&#46; En un seguimiento medio de 30 meses s&#243;lo un caso present&#243; reestenosis tard&#237;a que se repar&#243; mediante hepaticoyeyunostom&#237;a&#46; La mortalidad en nuestra experiencia ha sido nula&#46; <br/> <span class="elsevierStyleBold">Conclusiones&#46;</span> Dos factores a tener en cuenta en las lesiones de la v&#237;a biliar son la dificultad t&#233;cnica de la intervenci&#243;n y la experiencia del cirujano&#46; En las lesiones graves las anastomosis t&#233;rmino-terminales son las que m&#225;s &#237;ndice de reestenosis originan&#46; El empleo de tutores no ha mejorado los resultados en nuestra serie"
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        "resumen" => "<span class="elsevierStyleBold">Introduction&#46;</span> The incidence of surgical injury to the bile duct during open cholecystectomy ranges between 0&#46;2&#37; and 0&#46;5&#37;&#46; <br/> <span class="elsevierStyleBold">Patients and methods&#46;</span> A retrospective analysis of the iatrogenic bile duct injuries recorded in 1697 open cholecystectomies performed in our service between January 1986 and December 1995&#46; <br/> <span class="elsevierStyleBold">Results&#46;</span> There were 11 cases of surgical injury to the bile duct&#58; 3 of complete bile duct transection&#44; 2 of partial hepatic duct injury&#44; 2 of partial common bile duct injury&#44; 1 of failed cystic duct insertion&#44; 1 of common bile duct ligation and 2 of bile duct stenoses&#46; In 7 patients&#44; the diagnosis was made intraoperatively&#44; in 2 it was made during the first postoperative week and in the remaining 2&#44; 12 an 14 months later&#46; Surgical treatment involved end-to-end anastomosis in 2 cases&#44; hepaticojejunostomy in 3&#44; simple suture in 4&#44; suture plus T-tube drainage in 1 and section of the ligation in 1&#46; Most of the lesions &#40;80&#37;&#41; occurred during the course of cholecystectomy to treat acute cholecystitis &#40;p &#60; 0&#46;005&#41;&#46; Over a mean follow-up period of 30 months&#44; there has been only one case of late restenosis which was repaired by hepaticojejunostomy&#46; There were no deaths in our series of patients&#46; <br/> <span class="elsevierStyleBold">Conclusions&#46;</span>&#46; Two factors that must be taken into account in bile duct injury are the technical difficulty of the surgical procedure and the experience of the surgeon&#46; In severe lesions&#44; end-to-end anastomosis is the technique associated with the highest incidence of restenosis&#46; The use of stents did not improve the results in our series"
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