Colangiografia fluoroscópica transoperatoria: una mejor alternativa en cirugía laparoscópica / Fluoroscopic transoperative cholangiograpy: a better alternative in laparoscopy surgery

La endoscolecistectomia es la cirugía que se realiza más frecuentemente. La colangiografía trasoperatoria se realiza en todo paciente con sospecha de coledocolitiasis. La colangiografía estática convencional es usada entre los cirujanos de vías biliares. Nuestro objetivo es dar a conocer las ventajas de la fluoroscopia tales como menor irradiación, reducción del tiempo operatorio, mejor relación costo beneficio, mayor fidelidad para el diagnóstico de espasmo del esfinter de Oddi así como la facilidad para descartar artefactos. Presentamos la experiencia en 13 pacientes sometidos a endocolecistectomía en el Centro Clínico San Cristobal a quienes se les realizó colangiografía fluoroscópica transoperatoria

[Early gastric cancer in the remnant stomach. Case report]. / Cancer gastrico precoz en la boca anastomotica. Presentacion de un caso.

Patients with partial gastrectomy are a High risk group to develop gastric cancer. Risk is higher in remnant estomach after partial gastrectomy by malignancy than benign disease. We present a case of a male patient, 64 years old, who was admitted in our Hospital with Hypovolaemia. We found during Endoscopic examination early gastric Cancer IIc + III type in the site of anastomosis. Partial gastrectomy was performed in this patient by Duodenal ulcer 11 years ago.

[Pancreatic pseudocyst. A review of 10 years]. / Pseudoquiste pancreático. 10 años de revisión.

In the hope of finding those patients whose pancreas pseudocyst resolution were spontaneous, we undertook a retrospective review of such cases admitted at the Hospital Central de San Cristobal y Hospital Patrocinio Peñuela Ruiz (from IVSS), with the diagnosis of acute pancreatitis. From 619 patients with pancreatitis, 40 developed a pseudocyst (5.78%). The most frequent ethiology was biliary disease (47.5%) and abdominal pain in 87.5%, the most common symptom. Abdominal ultrasonography was the best diagnostic aid. Spontaneous resolution occur in 24 cases (60%) in juntion with the normalization of seric and urinary amylases values, the size of the cyst in these patients was less than 5 cms. Sixteen patients needed surgery, in 8 of them the seric amylase value remained high and in 3 cases this value was normal but with a cyst size more than five cms. Internal drainage in 11, external in 4 and surgical resection in one. There was no deaths in this review.

[Splenic abscess, a diagnostic and therapeutic problem]. / El absceso esplénico, un problema diagnóstico y terapeútico.

Splenic abscess remains a rare entity, reserved for patients with predisposing factors or immunosuppressive conditions. In our 13 patients in which a splenic abscess was diagnosed pre- or intra-operatively, an average of 14 days past before the diagnosis was made. Main symptoms were fever, upper left abdominal pain, auscultatory left basal anomalies and splenomegaly. Culture from the spleen material included E. coli, Staphylococcus, Proteus, Salmonella and Streptococcus v. Although splenectomy has been considered the standard procedure for this pathology, we treated our last three patients by means of Computed Tomography Percutaneous Drainage (C.T.G.P.D.). There was no need for splenectomy after this procedure and there were no complications associated with the C. T. G. P. D.