Ciencias de la Salud

URI permanente para esta comunidadhttp://repositorio.uta.edu.ec/handle/123456789/813

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Tiene archivos: SíTema: search.filters.subject.COLECISTECTOMÍA LAPAROSCÓPICA

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  • Miniatura
    Item type:Ítem,
    USO DE LA ESCALA DE PARKLAND EN EL ABORDAJE TRANSOPERATORIO DE COLECISTITIS AGUDA Y LA ELECCIÓN DE COLECISTECTOMÍA SUBTOTAL
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-24)
    Garcés Villacis, Roberth Paolo
    ;
    Loaiza Merino, Iván Patricio
    This investigation addresses the problem of acute cholecystitis, a sudden inflammation of the gallbladder that can become complicated and require laparoscopic cholecystectomy, the gold standard treatment. The study focuses on the complexity of this surgery, influenced by factors such as inflammation, the patient's clinical history and the condition of the gallbladder wall. It is noted that, although most cholecystectomies are successful, complex acute cholecystitis may require conversions to open surgery or changes in surgical technique, suggesting subtotal cholecystectomy as a rescue technique. The main objective is to analyze the medical literature to identify clinical factors that influence the choice of subtotal cholecystectomy and evaluate the relationship between Parkland Scale scores and the surgical decision, in order to establish its predictive validity. A methodological approach was used based on the review of cases of acute cholecystitis and the application of the Parkland Scale to predict surgical difficulty and the need for rescue techniques. The results show that the Parkland Scale is a useful tool to stratify disease severity and predict challenges during laparoscopic cholecystectomy, with a significant correlation between high scores and the choice of subtotal cholecystectomy. In conclusion, this study highlights the importance of the Parkland Scale and subtotal cholecystectomy in the management of complex acute cholecystitis, offering a valuable guide for clinical decision making in situations of difficult surgical access.
  • Miniatura
    Item type:Ítem,
    Técnicas de colecistectomía laparoscópica subtotal como estrategias de manejo en colecistectomías difíciles
    (Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2024-03-01)
    Castro López, Leonarda Nathaly
    ;
    Cadena Baquero, Juan Carlos Dr. Esp.
    Introduction: Laparoscopic cholecystectomy is one of the most frequent surgical procedures for symptomatic biliary pathology, with or without complications. There are determinants for identifying a difficult cholecystectomy, such as lack of surgeon's experience or clinical conditions that lead to variations in the biliary vascular anatomy, limiting the dissection of the hepatocystic triangle and preventing critical safety vision, leading to a higher risk of iatrogenic injuries and a greater rate of complications. Conventional cholecystectomy continues to be the Gold Standard in difficult cases. Therefore, consideration arises to opt for alternative surgical techniques among which laparoscopic subtotal cholecystectomy is found, which has gained relevance as a managem ent strategy in challenging gallbladder cases. Objective: To analyze laparoscopic subtotal cholecystectomy techniques as management strategies in difficult cholecystectomies through the review of existing scientific evidence. Materials and Methods: The theoretical foundation of this descriptive study is obtained through the analysis of literature from biomedical databases with the proper selection and extraction of relevant data for this review. Conclusions: Subtotal cholecystectomy has been proposed as a management strategy in challenging cases where total cholecystectomy is complicated by anatomical factors, severe inflammation, adhesions, or other complications. Subtotal cholecystectomy techniques, including fenestrated and reconstructive approaches, have become viable options as rescue strategies. However, their outcomes rely on the surgeon's experience, their selective use, and the risk-benefit consideration for each patient.