Coledocolitiasis

Facultad de Medicina de
Len
Dr. Jos Ral Hernndez Centeno
22 junio 2012

Objetivos
Definicin
Tratamiento
Conclusiones

Definicin
Coledocolitiasis
Litos en en coldoco

Colangitis
Obstruccin de la va biliar
Charcot

Dolor, Fiebre, Ictericia

Reynolds Choque y alt mentales

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Epidemiologa
10% de colelitiasis
Secundario 95%
Primario 5%

Complicaciones
Colangitis, pancreatitis, cirrosis, etc

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Diagnstico
Bilirrubinas
Fosfatasa alkalina
5 nucleotidasa
Amilasa pancreatitis
Leucos colangitis
Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Diagnstico
US
S 65% y E 70%
Dilatacin va biliar > 10 mm

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Diagnstico
CPRE

(Colangio

Pancreatografa

Retrgrada Endoscpica)
Estndar de oro
Diagnstico y
Riesgo alto de coldoco litiasis

Tratamiento
Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Diagnstico
Colecistectoma
Colangiotransoperatoria
Ultrasonido laparoscpico

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Diagnstico
EVB (exploracin)
Lito palpable
Colangitis
Lito en colangiografa

5% lito retenido
Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Tumores malignos y
benignos Vas Biliares
Facultad de Medicina de
Len
Dr. Jos Ral Hernndez Centeno
22 junio 2012

Carcinoma de
Vesicula

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Carcinoma de
Vesicula

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Carcinoma de
Vesicula

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Ciruga

Carbajo MA, Martn JC, Blanco JI, Cuesta C, Atienza R, Inglada L, et al. Tratamiento
de la colecistitis aguda en la era laparoscpica. Estudio comparativo laparoscopia
versus laparotoma. Rev Esp Enferm Digest 2007; 90:788-90.

Colangiocarcino
ma

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Colangiocarcino
ma

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Colangiocarcino
ma

Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long
Term Eff Med Implants. 2005;15(3):329-38

Pregunta

Debo
operarlo?

Conclusiones
Colangitis evitarlo
Cancer

raul.cirugia@gma
raul.cirugia@gmail.com
il.com