Prevalencia y factores asociados a coledocolitiasis en el Hospital Vicente Corral Moscoso, Cuenca 2014
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Date
2016
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Abstract
Introduction: Choledocholithiasis is the most frequent complication of cholelithiasis which is located on the second place of the acute abdominal pathology observed in the emergency services. Different series referred that approximately 15% to 30% of gallstones migrate into the common bile duct.
Objective: Determine the prevalence of choledocholithiasis and associated factors in the patient received in the emergency room of the Hospital Vicente Corral Moscoso, Cuenca 2014.
Material and methods: a cross-sectional descriptive study was conducted in patients treated in the emergency room at the Vicente Corral Moscoso Hospital. The study sample was 258 patients. Nutritional status (weight and height) was assessed, laboratory tests: hematological, biochemical, imaging and use of complementary methods such as ERCP, CRM or exploration of bile ducts.
Results: The prevalence of choledocholithiasis in patients with biliary disease in the service of surgery and emergency of Vicente Corral Moscoso Hospital is 67.80 per cent IC95 %: 26 - 74 %. It is most common between 25 and 49 years with the 36.0 % IC95 %: 30 - 42% in women with the 74.9 % 95 %: 70 - 80 %. The main symptom observed in patients with choledocholithiasis was nausea 88.6 %, choluria 67.4 %, 66.9 % jaundice and moderate pain 40.6 %. All the patients underwent ultrasound. Endoscopic retrograde cholangiopancreatography was requested to the 96.6% of patients, the magnetic cholangioresonance to 48% and the exploration of bile ducts such as procedure during surgery in the 17.1 % of patients. The 27.4% of patients had a previous surgery. It was noted that there is statistically significant association with age OR 2.46 ; 95% CI 1.14 - 4.28 , p= 0.001 and the values of total bilirubin , alkaline phosphatase, gamma glutamyl transferase and diameter of the common bile duct.
Conclusions: The prevalence of choledocholithiasis is high and is associated to age, total bilirubin , alkaline phosphatase, gamma glutamyl transferase and diameter of the common bile duct
Resumen
Introducción: La coledocolitiasis es la complicación más frecuente de la colelitiasis, ubicada en el segundo lugar de la patología abdominal aguda observada en los servicios de emergencia. Entre un 15% a 30% de los cálculos de la vesícula migran al colédoco.
Objetivo: determinar la prevalencia de coledocolitiasis y los factores asociados en los pacientes atendidos en el la emergencia del HVCM.
Material y métodos: Estudio transversal en pacientes del servicio de emergencia del HVCM en el 2014. Muestra de 258 pacientes. Evaluando IMC, laboratori; bioquímico, imagenológico y métodos complementarios como colangiopancreatografía retrógrada endoscópica, colangioresonancia magnética o exploración de vías biliares.
Resultados: La prevalencia fue del 67,80% IC95%: 26 - 74%. Más frecuente entre los 25 y 49 años con el 36,0% IC95%: 30 - 42% y en las mujeres con el 74,9% IC95%: 70 - 80%. El principal síntoma fue la náusea 88,6%, coluria 67,4%, ictericia 66,9% y dolor moderado 40.6%. A todos los pacientes se les realizó ecografía. La CPRE se solicitó al 96.6%, la CRM al 48% y la exploración de vías biliares se realizó al 17,1% de pacientes. El 27.4% manifestó antecedente de cirugía previa. Existe asociación estadísticamente significativa con la edad OR 2.46; IC95% 1.14 - 4.28, p= 0.001, y los valores de bilirrubina total, fosfatasa alcalina, gammaglutamil transferasa y el diámetro del colédoco.
Conclusiones: la prevalencia de coledocolitiasis es alta y está asociada a la edad y los valores de bilirrubina total, FA, GGT y diámetro del colédoco
Keywords
Coledocolitiasis, Factores Asociados, Cirugia
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MEDCG;64