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2013, Número 2

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Mediciego 2013; 19 (2)


Apuntes históricos sobre el tratamiento quirúrgico de la pancreatitis aguda severa

Camacho AV, Morales MLA, Jiménez RD, Borjas FGE

Idioma: Español
Referencias bibliográficas: 47
Paginas:
Archivo PDF: 72.33 Kb.


RESUMEN

Se discute la evolución del tratamiento quirúrgico de la pancreatitis aguda severa, sobre la base del análisis y fundamentación cronológica de las publicaciones originales, que aparecen particularmente referenciadas. Durante las primeras seis décadas del siglo XX, la cirugía ablativa radical y temprana en el tratamiento de la pancreatitis aguda severa era ampliamente practicada en Europa y América, con mortalidad promedio superior al 60%. A finales de la década de los 60, aparecen los primeros reportes que demuestran que los tratamientos quirúrgicos menos radicales eran más efectivos y se suceden con rapidez gran número de publicaciones que paulatinamente reportan los beneficios de técnicas quirúrgicas más conservadores de desbridamiento y drenaje de las áreas de necrosis pancreáticas infectadas. Simultáneamente se establece las ventajas del tratamiento médico conservador y los procedimientos quirúrgicos de re-intervención planificada y tardía en la necrosis pancreática. Se destacan además, las ventajas de un grupo de novedosas técnicas mínimamente invasiva de drenaje y desbridamiento guiadas por imágenes o endoscopia, las cuales han ganado aceptación general de forma rápida y convincente y cuyo futuro es altamente prometedor.


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