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1999, Número 2

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Rev Med Hosp Gen Mex 1999; 62 (2)


Manejo actual de la coledocolitiasis

García GVA, Zárate GAM, Corral MA, Pérez TE

Idioma: Español
Referencias bibliográficas: 41
Paginas: 121-127
Archivo PDF: 77.47 Kb.


RESUMEN

Se describe la frecuencia de la coledocolitiasis y se analizan las diferentes opciones terapéuticas disponibles. Desde el punto de vista no quirúrgico, son descritas en general las técnicas, su frecuencia de éxito y complicaciones, así como las ventajas principales para la colangiopancreatografía retrógrada endoscópica convencional, la litotripsia mecánica, electrohidráulica y con rayo láser; se menciona la utilidad de la litotripsia extracorpórea, la colocación de prótesis endobiliares y el manejo disolutivo con mono-octanoína. En el paciente posoperado y con presencia de sonda en T en el colédoco, resulta de gran utilidad el abordaje radiológico intervencionista. Por otro lado, las opciones quirúrgicas se han enriquecido con la cirugía laparoscópica o de invasión mínima, cuyo desarrollo ofrece una exploración transoperatoria tan eficaz como la de la cirugía abierta. Finalmente, se discute la elección de alguna opción dependiendo de factores como la edad, el sexo, etcétera.


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