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Inicio Cirugía Española Exploración laparoscópica de la vía biliar. Experiencia de una unidad especia...
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Vol. 71. Núm. 6.
Páginas 292-295 (junio 2002)
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Vol. 71. Núm. 6.
Páginas 292-295 (junio 2002)
Acceso a texto completo
Exploración laparoscópica de la vía biliar. Experiencia de una unidad especializada
Laparoscopic bile duct exploration. Experience in a specialized unit
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6813
John Griniatsosa,1
Autor para correspondencia
a.isla@ic.ac.uk

Correspondencia: Dr. A.M. Isla. Ealing Hospital. Uxbridge Road. Southall. Middlesex. UB1 3HW. Reino Unido.
, Andrew Wanb, Shadi Ghalic, Melissa Bentleyd, Alberto M. Islae
a Trust Surgeon.
b Specialist Registrar.
c Senior House Officer.
d Senior House Officer. Ealing Hospital.
e Consultant. Ealing/Hammersmith Hospital. NHS Trust. Southall. Middlesex. Reino Unido.
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Información del artículo
Resumen
Introducción

En la actualidad no está claro cuál es el mejor abordaje para la coledocolitiasis con vesícula in situ. Recientemente en algunos centros se ha adoptado la exploración laparoscópica de la vía biliar (ELVB) como técnica de elección.

Material y métodos

Presentamos la experiencia de ELVB en una unidad con especial interés en cirugía laparoscópica. Durante 30 meses 44 pacientes con una edad mediana de 65 años y sospecha de litiasis de la vía biliar principal fueron intervenidos por laparoscopia.

Resultados

En más del 90% se completó la extracción de cálculos laparoscópicamente y sólo un paciente requirió conversión a cirugía abierta. Un 18% presentó complicaciones y hubo un fallecimiento en un paciente de 75 años debido a una complicación con el tubo en “T”.

Conclusiones

Consideramos que, en manos entrenadas, el abordaje laparoscópico de la vía biliar tiene al menos los mismos resultados que el abordaje tradicional (colangiopancreatografía retrógrada endoscópica [CPRE]) con menos ingresos y probablemente inferior mortalidad en el grupo de enfermos jóvenes.

Palabras clave:
Colédoco
Coledocolitiasis
Coledocotomía
Introduction

What constitutes the best treatment for common bile duct stones with gallbladder in situ is currently unclear? The recently introduced laparoscopic bile duct exploration is considered by some groups to be the preferred approach.

Material and methods

We present our experience of laparoscopic bile duct exploration in a unit with a special interest in laparoscopic surgery. Over a period of 30 months, 44 patients with a median age of 65 years and suspected common bile duct stones underwent laparoscopic bile duct exploration.

Results

Complete clearance of the bile duct was achieved in 90% of the patients and only one patient required conversion to open surgery. The overall complication rate was 18%. There was one death in a 75-year-old patient secondary to a T-tube related complication.

Conclusions

We consider that, in experienced hands, laparoscopic bile duct exploration provides similar results to those obtained with the traditional approach (endoscopic retrograde cholangiopancreatography). Fewer admissions are required and in young patients mortality is probably lower.

Key words:
Common bile duct calculi
Bile duct
Cholechotomy
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Copyright © 2002. Asociación Española de Cirujanos
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