Browsing by Author "Arteaga Huiracocha, Jorge Alejandro"

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A case report: regarding transduodenal sphincteroplasty
(2021) Ordoñez Velecela, Maria Soledad; Arteaga Huiracocha, Jorge Alejandro; Himmler, Amber N; Reinoso, Jeovanni; Salamea Molina, Juan Carlos
Introduction: Stenosing papillitis is rare. It can be primary or secondary and occurs due to the presence of stones in the common bile duct. The initial treatment of choledocholithiasis is endoscopic retrograde cholangiopancreatography (ERCP). However, when ERCP is unsuccessful, the transduodenal sphincteroplasty is an alternative strategy that obtains satisfactory results in select patients. Case description: A 27-year-old female patient presents right-upper quadrant pain associated with scleral icterus. She had choledocholithiasis and cholestasis. The ERCP performed was failed, so an open cholecystectomy with common bile duct exploration was undertaken. As the ampulla could not be cannulated, a “T” tube was placed. On a postoperative day 15, a cholangiography was performed without evidence of contrast passage into the duodenum. A re-exploration of the bile duct was undertaken 30 days after and a papillary exploration through a transduodenal approach was performed. A new cholangiography was done on postoperative day 9, at which point adequate passage of contrast into the duodenum was appreciated. Conclusion: Transduodenal sphincteroplasty is a procedure rarely performed in the era of endoscopy. Nonetheless, when these cases do come up, knowing the appropriate surgical technique is crucial to obtain satisfactory results for the patient.
Enfisema lobar congénito en un recién nacido. Reporte de caso.
(2021) Ordoñez Velecela, Maria Soledad; Arteaga Huiracocha, Jorge Alejandro; Marcano Sanz, Luis Enrique; Endis Miranda, Miurkis
Pandemia en quirófano: mente alerta y manos ágiles
(Abya-Yala, 2021) Martínez Pérez, Alejandro; Ordoñez Velecela, Maria Soledad; Arteaga Huiracocha, Jorge Alejandro; Jaramillo Monge, Kadir
Prevalencia y factores asociados de la coledocolitiasis en pacientes de 20 a 60 años de edad del servicio de emergencia de cirugía. Hospital Vicente Corral Moscoso. Cuenca- Ecuador, 2020
(Universidad de Cuenca, 2022-02-11) Arteaga Huiracocha, Jorge Alejandro; Maldonado López, Carlos Eduardo; Morocho Malla, Manuel Ismael
Background: Choledocholithiasis is an emergency in the presence of symptomatic cholelithiasis. For diagnosis, clinical, biochemical and biliary tract ultrasound parameters are considered in predictive models that guide the performance of Endoscopic Retrograde Cholangiopancreatography (ERCP) to help diagnosis and intervention. Objective: to identify the prevalence of choledocholithiasis and its associated factors in patients between 20 and 60 years of age in the emergency department of Vicente Corral Moscoso Hospital during the year 2020. Materials and methods: quantitative cross-sectional analytical design. Sample of 118 (N144) patients with symptomatic cholecystitis. Clinical, biochemical and ultrasound data were collected from the clinical history: age, sex, clinical and biochemical characteristics, history of cholecystectomy and stone extraction, overweight/obesity. The ASGE -2010 model and ERCP were used. Descriptive and bivariate analysis was performed with chi-square, prevalence ratio and 95%CI. Results: 27.1% (95%CI 26.4 to 27.9) of the patients in the study presented choledocholithiasis diagnosed by CPRE. Thirty-nine percent had obesity. Mean bilirubin, TGO, TGP and alkaline phosphatase tests were higher than normal values, 36% of cases had positive EUS. Choledocholithiasis had no statistical relationship (p>0.05) with: sex, age older than 55 years, history of cholecystectomy, history of common bile duct stone extraction, overweight/obesity, pancreatitis complication; there was relationship with cholangitis complication (p<0.05; PR: 5.9; 95%CI: 3.7-9.4). Conclusions: CPRE is important in the diagnosis of choledocholithiasis when following the ASGE-2010 model. More studies on the subject are needed.