Diagnóstico y tratamiento de la pancreatitis aguda en la Argentina. Resultados de un estudio prospectivo en 23 centros.

In Argentina there are no multicenter studies evaluating the management of patients with acute pancreatitis (AP) nationwide. OBJECTIVES: The main objective of this study is to know how the patients with AP are treated in Argentina. The secondary objective is to assess whether the results comply with the recommendation of the American College of Gastroenterology Guide. MATERIAL AND METHODS: Twenty three center participated in the study. They include in a database hosted online consecutive patients with acute pancreatitis from june 2010 to june 2013. RESULTS: 854 patients entered the study. The average age was 46.6 years and 495 (58%) belonged to the female sex. The most common cause (88.2%) of AP was biliary. Some prognostic system was used in 99 % of patients and the most used was Ranson (74.5%). Were classified as mild 714 (83.6%) patients and severe 140 (16.4%). Systemic complications occurred in 43 patients and local complications in 21. 86 patients underwent dynamic CT scans and 73 patients had pancreatic and / or peripancreatic necrosis. Mortality was 1.5%. There was no difference in mortality in relation to the size, complexity or affiliation of the center. The comply of key recommendations of the American College of Gastroenterology Guide was over 80%. CONCLUSIONS: The diagnosis and treatment of patients with AP in 23 health centers located throughout the country was optimal. The management complied with most of the recommendations of the American College of Gastroenterology Guide.

Diagnóstico y tratamiento de la pancreatitis aguda en la Argentina. Resultados de un estudio prospectivo en 23 centros.

In Argentina there are no multicenter studies evaluating the management of patients with acute pancreatitis (AP) nationwide. OBJECTIVES: The main objective of this study is to know how the patients with AP are treated in Argentina. The secondary objective is to assess whether the results comply with the recommendation of the American College of Gastroenterology Guide. MATERIAL AND METHODS: Twenty three center participated in the study. They include in a database hosted online consecutive patients with acute pancreatitis from june 2010 to june 2013. RESULTS: 854 patients entered the study. The average age was 46.6 years and 495 (58%) belonged to the female sex. The most common cause (88.2%) of AP was biliary. Some prognostic system was used in 99 % of patients and the most used was Ranson (74.5%). Were classified as mild 714 (83.6%) patients and severe 140 (16.4%). Systemic complications occurred in 43 patients and local complications in 21. 86 patients underwent dynamic CT scans and 73 patients had pancreatic and / or peripancreatic necrosis. Mortality was 1.5%. There was no difference in mortality in relation to the size, complexity or affiliation of the center. The comply of key recommendations of the American College of Gastroenterology Guide was over 80%. CONCLUSIONS: The diagnosis and treatment of patients with AP in 23 health centers located throughout the country was optimal. The management complied with most of the recommendations of the American College of Gastroenterology Guide.

Colangio colecistocolangiografía percutánea ecoguiada / Percutaneous cholecystocholangiography guided by US

Se presenta un procedimiento diagnóstico intervencionista imagenológico para el estudio del paciente portador de patología biliar obstructiva, con duda diagnóstica tanto en su etiología como en su localización topográfica, con los métodos convencionales ecográficos y tomográficos. El mismo combina el método ecográfico, para la guía de las aguja de punción percutánea, hasta el interior del árbol biliar, y el método radiológico que permite graficar después de la inyección de un medio de contraste permitiendo: -Una correcta localización topográfica de la lesión. -Una reducción de los diagnósticos presuntivos de la patología causal. -Una menor morbilidad respecto de la colangiografía transparietohepática convencional al efectuarse una sola punción hepática. -Una imagen absolutamente limpia de la vía biliar contrastada. Los riesgos fueron mínimos, no hubo complicaciones, siendo las contraindicaciones del mismo, las de la punción hepática y la alergia a los compuestos yodados

Cáncer avanzado de vesícula biliar / Advanced gallbladder cancer

Se presenta la experiencia de nuestro Servicio en el estudio, tratamiento y seguimiento durante 4 años de 17 casos de esta patología. La utilización de nueva metodología diagnóstica, la precisión de pautas quirúrgicas específicas y la adopción de técnicas más agresivas constituyeron el intento por mejorar la sobrevida de estos pacientes en cuanto a calidad y cantidad de vida. Al mismo tiempo se efectuó una revisión de la metodología más moderna para su estudio y tratamiento.

Traumatismos de recto por cuerpos extraños / Traumas of the rectum by foreign bodies

Se presentaron 14 casos de cuerpos extraños en recto, mencionando la metodología diagnóstica y la conducta terapéutica empleada en cada