Jiménez PMJ

Language: Spanish
References: 10
Page: 53-58
PDF size: 190.27 Kb.

ABSTRACT

Objective: To determine risk factors such as gender, age and serum amylase levels to develop acute pancreatitis after ERCP in patients diagnosed with choledocholithiasis and / or biliary cholangitis, in the San Juan de Dios Hospital in 2013. Methods: The study is a transversal and descriptive non experimental investigation in which, after approval by the Bioethics Committee of the hospital, 115 files of patients who met the inclusion criteria were reviewed; using for the data collection the admission form, together with the medical story of each patient included in this study. Results: We determined that within the population the most affected are those between the age of 25-54 years to 43.4%. There is a female predominance since 74.7% of the patients that were subjected to a ERCP were woman. Also it was determined that choledocholitiasis was the most common diagnosis, being 90.4%. Of the total population that underwent the ERCP, only 33.9% were measured the serum amylase after the procedure and 25.6% of them presented amylase three times above normal. The sensitivity of serum amylase in the study is 75% and specificity is 96% longer than 6% of patients, 2.5% had elevated amylase. Nationally, in the San Juan de Dios Hospital incidence of acute pancreatitis after ERCP during 2013 corresponds to 8.69%. The presentation and progression of acute pancreatitis after ERCP procedure is well documented in the literature and requires the physician to evaluate this possibility, especially because of the potential risk that this complication could have on patients.

REFERENCES

1. Brunicardi, C.F., Andersen, D.K., Billiar, T.R., Dunn, D.L., Hunter, J.G, Matthews, J.B. y Pollock, R.E. (2009) Páncreas. En Schwartz, Principios de Cirugía (pp. 1167- 1243). México, D.F: McGraw-Hill Interamericana.

2. Cappell, M. (2008). Acute Pancreatitis: Etiology, Clinical Presentation, Diagnosis and Therapy. The Medical Clinic of North America, 92, 889-923.

3. Cotton, P., Garrow, D. y Gallagher, J. (2009).Factores de riesgo para complicaciones posteriores a colangiopancreatografía retrógrada endoscópica: análisis multivariado de 11 497 procedimientos en 12 años. Ecos de la Gastroenterología, 279-280.

4. Gómez, M., Delgado, L. y Arbeláez, V. (2012) Factores de riesgo asociados a pancreatitis ehiperamilasemiapostcolangio pancreatografía retrógrada endoscópica (CPRE). Revista Colombiana de Gastroenterologìa, 27 (1), 7-20.

5. Gompertz, M., Fernández, L., Lara, I., Miranda, J., Mancilla, C. y Berger, Z. (2012). Índice clínico de gravedad en pancreatits aguda: BISAP (Besideindexforseverity in pancreatitis acute). Dos años de experiencia en el Hospital Clínico Universidad de Chile. Revista Médica de Chile, 140, 977-983.

6. Quispe, A., Sierra, W., Callacondo, D y Torreblanca J. (2010) Factores asociados a complicaciones de la colangiopancreatografìa retrógrada endoscópica en un hospital de alta complejidad. Revista Peruana de Medicina Experimental y Salud Pública, 27 (2), 201-208.

7. Ramos, C., Hernández, Y. y Del Valle P. (2013).Colangiopancreatografía Retrógrada Endoscópica en un hospital de nivel secundario. Revista Médica Electrón, 564-574.

8. Tenner, S., Baillie, J., DeWitt, J. y Vege, S. (2013). American College of Gastroenterology Guideline: Management of Acute Pancreatitis. The American Journal of Gastroenterology, 108, 1400-1415.

9. Toh, S.K., Phillips, S., Johnson, C.D. (2000). A prospective audit against national standardsof the presentation and management of acute pancreatitis in the South of England. GUT, 46, 239-243.

10. Zolezzi, A., González, P., Salomon, C., Castillo J. y Saed, N. (2009). Pancreatitis aguda severa temprana postcolangiopancreatografìa retrógrada endoscópica, presentación de un caso. Medigraphic, 10 (1), 40- 44.