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OPTIMIZACIÓN EN LA ESTRATEGIA DIAGNÓSTICA Y TERAPÉUTICA EN EL QUISTE DE COLÉDOCO.

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Title: OPTIMIZACIÓN EN LA ESTRATEGIA DIAGNÓSTICA Y TERAPÉUTICA EN EL QUISTE DE COLÉDOCO.
Alternate Title: Optimization in diagnostic and therapeutic strategy of choledochal cyst.
Authors: Vivas-Colmenares, Grecia Victoria1 greciavc_10@hotmail.com, Millán-López, Ana1, De Agustín A., Juan Carlos1
Source: Revista Chilena de Cirugia. Jun2015, Vol. 67 Issue 3, p278-284. 7p.
Abstract (English): Objectives: The choledochal cyst has an incidence of 1 in 100.000-150.000. The purpose of this study was to analyze the variables introduced for the optimization in the diagnosis and treatment of choledochal cyst. Material and Methods: Retrospective study of patients treated in our center by hepatic-jejunostomy and Roux-Y, from September 1988 to November 2012. We analyzed 40 variables including age, symptoms, type of cysts, diagnostic tests, changes in surgical technique, complications and outcomes. Results: Eighteen patients (66.6% female) were grouped according to the age of presentation: Prenatal (< 1 month), Early (1-24), Delayed (> 24 months). The most common symptoms were jaundice and abdominal pain (for early-onset and late-onset respectively). The 83.3% presented choledochal cysts type I, the ultrasound was sufficient for diagnosis in 94.4%. Since 2004 we modified the surgical technique, performing laparoscopic dissection of the bile duct and cyst, adding a mini-laparotomy (3-5 cm) for hepatic-jejunostomy with 40 cm intestinal loop using polypropylene suture. One complication was observed since 2004, one case of partial dehiscence of the anastomosis resolved with conservative treatment and a cholangitis in 1 patient with hepatic and renal polycystic. In 2012, 83.3% are asymptomatic. Conclusions: The diagnostic have been simplified, in more than 90% of cases was done by ultrasound; advances in minimally invasive surgery and creation of descending loop of 40 cm, have helped to improve the prognosis of choledochal cyst. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivos: El quiste de colédoco presenta una incidencia de 1 en 100.000-150.000. El propósito de este estudio fue analizar las variables introducidas para la optimización en el diagnóstico y tratamiento del quiste de colédoco. Material y Métodos: Estudio retrospectivo de pacientes intervenidos en nuestro centro de quiste de colédoco mediante hepático-yeyunostomía en Y de Roux, desde septiembre de 1988 a noviembre de 2012.Se analizan 40 variables incluyendo edad, sintomatología, tipo de quiste, pruebas diagnósticas, cambios en la técnica quirúrgica, complicaciones y evolución. Resultados: 18 pacientes (66,6% mujeres) fueron agrupados de acuerdo a la edad de presentación: Prenatal (< 1 mes); Precoz (1-24 meses); Tardía (> 24 meses). Los síntomas más frecuentes fueron ictericia y dolor abdominal (para los de inicio precoz y tardío respectivamente). El 83,3% presentaban quistes de colédoco tipo I; siendo suficiente la ecografía para el diagnóstico en el 94,4%. A partir de 2004 modificamos la técnica quirúrgica, realizando por vía laparoscópica la disección de la vía biliar y mediante laparotomía mínima (3-5 cm) hepático-yeyunostomía con asa descendente de 40 cm, empleando sutura de polipropileno, observando desde el 2004, sólo 1 dehiscencia parcial de la anastomosis, resuelta con tratamiento conservador y 1 colangitis en paciente con poliquistosis hepática y renal. En el año 2012 el 83,3% están asintomáticos. Conclusiones: El diagnóstico se ha simplificado, en más de 90% de los casos se realiza sólo con ecografía; los avances en cirugía mínimamente invasiva y la creación de asa descendente de 40 cm, han logrado optimizar el pronóstico del quiste de colédoco. [ABSTRACT FROM AUTHOR]
Copyright of Revista Chilena de Cirugia is the property of Sociedad de Cirujanos de Chile and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Optimization in diagnostic and therapeutic strategy of choledochal cyst.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vivas-Colmenares%2C+Grecia+Victoria%22&quot;&gt;Vivas-Colmenares, Grecia Victoria&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; greciavc_10@hotmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mill&#225;n-L&#243;pez%2C+Ana%22&quot;&gt;Mill&#225;n-L&#243;pez, Ana&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22De+Agust&#237;n+A%2E%2C+Juan+Carlos%22&quot;&gt;De Agust&#237;n A., Juan Carlos&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Revista+Chilena+de+Cirugia%22&quot;&gt;Revista Chilena de Cirugia&lt;/searchLink&gt;. Jun2015, Vol. 67 Issue 3, p278-284. 7p.
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objectives: The choledochal cyst has an incidence of 1 in 100.000-150.000. The purpose of this study was to analyze the variables introduced for the optimization in the diagnosis and treatment of choledochal cyst. Material and Methods: Retrospective study of patients treated in our center by hepatic-jejunostomy and Roux-Y, from September 1988 to November 2012. We analyzed 40 variables including age, symptoms, type of cysts, diagnostic tests, changes in surgical technique, complications and outcomes. Results: Eighteen patients (66.6% female) were grouped according to the age of presentation: Prenatal (&lt; 1 month), Early (1-24), Delayed (&gt; 24 months). The most common symptoms were jaundice and abdominal pain (for early-onset and late-onset respectively). The 83.3% presented choledochal cysts type I, the ultrasound was sufficient for diagnosis in 94.4%. Since 2004 we modified the surgical technique, performing laparoscopic dissection of the bile duct and cyst, adding a mini-laparotomy (3-5 cm) for hepatic-jejunostomy with 40 cm intestinal loop using polypropylene suture. One complication was observed since 2004, one case of partial dehiscence of the anastomosis resolved with conservative treatment and a cholangitis in 1 patient with hepatic and renal polycystic. In 2012, 83.3% are asymptomatic. Conclusions: The diagnostic have been simplified, in more than 90% of cases was done by ultrasound; advances in minimally invasive surgery and creation of descending loop of 40 cm, have helped to improve the prognosis of choledochal cyst. [ABSTRACT FROM AUTHOR]
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  Data: Objetivos: El quiste de col&#233;doco presenta una incidencia de 1 en 100.000-150.000. El prop&#243;sito de este estudio fue analizar las variables introducidas para la optimizaci&#243;n en el diagn&#243;stico y tratamiento del quiste de col&#233;doco. Material y M&#233;todos: Estudio retrospectivo de pacientes intervenidos en nuestro centro de quiste de col&#233;doco mediante hep&#225;tico-yeyunostom&#237;a en Y de Roux, desde septiembre de 1988 a noviembre de 2012.Se analizan 40 variables incluyendo edad, sintomatolog&#237;a, tipo de quiste, pruebas diagn&#243;sticas, cambios en la t&#233;cnica quir&#250;rgica, complicaciones y evoluci&#243;n. Resultados: 18 pacientes (66,6% mujeres) fueron agrupados de acuerdo a la edad de presentaci&#243;n: Prenatal (&lt; 1 mes); Precoz (1-24 meses); Tard&#237;a (&gt; 24 meses). Los s&#237;ntomas m&#225;s frecuentes fueron ictericia y dolor abdominal (para los de inicio precoz y tard&#237;o respectivamente). El 83,3% presentaban quistes de col&#233;doco tipo I; siendo suficiente la ecograf&#237;a para el diagn&#243;stico en el 94,4%. A partir de 2004 modificamos la t&#233;cnica quir&#250;rgica, realizando por v&#237;a laparosc&#243;pica la disecci&#243;n de la v&#237;a biliar y mediante laparotom&#237;a m&#237;nima (3-5 cm) hep&#225;tico-yeyunostom&#237;a con asa descendente de 40 cm, empleando sutura de polipropileno, observando desde el 2004, s&#243;lo 1 dehiscencia parcial de la anastomosis, resuelta con tratamiento conservador y 1 colangitis en paciente con poliquistosis hep&#225;tica y renal. En el a&#241;o 2012 el 83,3% est&#225;n asintom&#225;ticos. Conclusiones: El diagn&#243;stico se ha simplificado, en m&#225;s de 90% de los casos se realiza s&#243;lo con ecograf&#237;a; los avances en cirug&#237;a m&#237;nimamente invasiva y la creaci&#243;n de asa descendente de 40 cm, han logrado optimizar el pron&#243;stico del quiste de col&#233;doco. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Revista Chilena de Cirugia is the property of Sociedad de Cirujanos de Chile and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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              Text: Jun2015
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