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2005, Número 3

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Cir Gen 2005; 27 (3)


Cirugía laparoscópica intragástrica (Endoluminal), informe de dos pacientes

Terrazas EF, Galindo NA, Orduña D, Sanjurjo GJL, Solana LJ, Suárez ME

Idioma: Español
Referencias bibliográficas: 55
Paginas: 222-228
Archivo PDF: 158.91 Kb.


RESUMEN

Objetivo:Describir la experiencia con dos casos clínicos en los que se empleó cirugía laparoscópica intragástrica.
Sede:Hospital de tercer nivel de atención.
Descripción de los casos:
Caso 1: Mujer de 76 años de edad con hemorragia digestiva secundaria a úlcera gástrica hemorrágica en la unión del cuerpo y del antro, cara posterior, no excavada, se trató con escleroterapia con adrenalina y polidiocanol con lo que cedió la hemorragia. Siete días después nuevo episodio de hemorragia por la misma causa. Se abordó la cavidad gástrica por vía anterior, se introdujo dentro del estómago un trócar “blunt tip” de 11 mm, luego laparoscopio de 30° y posteriormente dos trócares de 5 y 10 mm, se revisó el estómago, se visualizó la úlcera y se colocaron cuatro puntos hemostáticos, calibre dos ceros con nudos extracorpóreos. Un año y medio después se encuentra asintomática.
Caso 2: Hombre de 47 años, con historia de alcoholismo crónico, dos episodios previos de pancreatitis 7 y 5 años antes. Ingreso por dolor abdominal y, se palpó en epigastrio, una masa fija a planos profundos, renitente y dolorosa, exámenes de amilasa con 706 U y lipasa de 108 U. El ultrasonido y la tomografía demostraron un pseudoquiste en el cuerpo del páncreas con paredes de 0.7 cm y diámetro de 15 cm. Se realizó panendoscopia que corroboró el diagnóstico. Utilizando laparoscopia se destechó el pseudoquiste en un área de 1.5 cm de diámetro drenando el líquido contenido. Se da de alta al tercer día. Cuatro meses después se encuentra asintomático.
Conclusión:Es técnicamente posible emplear con éxito la cirugía endoluminal, intragástrica, como cirugía de mínima invasión.


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