Procedimientos de rescate en colecistectomía laparoscópica: cómo finalizar con seguridad por laparoscopía
Resumen
Los procedimientos de rescate en colecistectomía laparoscópica son variados. Objetivos: Describir los procedimientos de rescate usados en el Hospital Regional ISSSTE Puebla durante el 2022. Material y métodos: Estudio observacional descriptivo, prospectivo de corte trasversal, en donde se incluyeron pacientes en los cuales no se pudo completar la visión crítica de seguridad y por lo tanto se tuvo que usar algún procedimiento de rescate para completar la colecistectomía por laparoscopía. Resultados: Se realizaron 193 colecistectomías laparoscópicas, en 40 (20.7%) pacientes se empleó algún procedimiento de rescate, se convirtieron 4 (2%) pacientes. Mediante el análisis multivariado no hubo relación significativa entre el tipo de procedimiento y el género, la edad, así como el grado de severidad de Tokyo; pero si hubo relación significativa el puntaje de Parkland ≥4 con los siguientes procedimientos: "Fundus first" más "punción y aspiración", colecistectomía reconstitutiva, abordaje infundibular, abordaje del segmento IV, colocación de un puerto adicional, colecistectomía parcial con o sin colangiografía, y el abordaje del ganglio cístico. Los días de estancia hospitalaria mayores se relacionaron con la colecistectomía reconstitutiva, colecistectomía parcial y la conversión. El sangrado se relacionó con la necesidad de conversión y con el uso de la "punción y aspiración".
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Derechos de autor 2023 Carlos de Jesús Hernández López;Luis Alan Escobar Sánchez;Jon Mikel Rementeria Vázquez;Zaid Toledo Guzmán;Luis Arturo Ramírez Riva Palacio;Rodolfo Enríquez Salinas;Juan José Sánchez Sánchez
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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