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2015, Número 3-4

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Cir Gen 2015; 37 (3-4)


Reconstrucción de la vía biliar, secundaria a lesiones mayores iatrogénicas

Bonifaz CJE, Palacio VAF
Texto completo Cómo citar este artículo 10.35366/65750

DOI

DOI: 10.35366/65750
URL: https://dx.doi.org/10.35366/65750
Artículos similares

Idioma: Español
Referencias bibliográficas: 53
Paginas: 70-81
Archivo PDF: 303.40 Kb.


PALABRAS CLAVE

Colédoco, lesión, reconstrucción, vía biliar.

RESUMEN

Antecedentes: La lesión de vía biliar es una de las complicaciones más temidas, peligrosas y que aumentan la morbimortalidad. Con la colecistectomía laparoscópica se incrementó la incidencia de lesión hasta que se estabilizó en un 1.3%, lo cual es aún alto para el 0.6% de la era abierta. El objetivo es mostrar la experiencia de la unidad hospitalaria en el manejo de la lesión de vía biliar en un periodo de 30 años. Material y métodos: Éste es un estudio retrospectivo, descriptivo, observacional en pacientes del Servicio de Cirugía General del Hospital Regional “General Ignacio Zaragoza” en el periodo comprendido de 1980 a 2009, con análisis de expedientes clínicos, estudios de laboratorio e imágenes de control y seguimiento de los pacientes intervenidos quirúrgicamente. Se incluyeron, solamente, individuos con lesiones mayores de vía biliar con diagnóstico trans- y postoperatorio sometidos a reconstrucción de la misma. Se intervinieron 67 sujetos, de los cuales 58 eran mujeres y nueve hombres. Resultados: El tipo de lesión más frecuente fue Bismuth III y el procedimiento quirúrgico más utilizado fue la hepaticoyeyunoanastomosis en Y de Roux, en 54 de ellos, con un 5.2% de mortalidad en los primeros 13 meses y un 89.5% de éxito en el primer año de seguimiento. Conclusiones: La incidencia de la lesión de la vía biliar durante un procedimiento quirúrgico es baja en centros de concentración y alta especialidad. Es imperativo para el cirujano conocer las alternativas diagnósticas y quirúrgicas al enfrentar este tipo de lesiones.


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