RESUMO
BACKGROUND: The ERCP procedure requires the use of fluoroscopy with the subsequent exposure to ionizing radiation. The doses received by patients, physicians and assistants in the endoscopy have never been recorded in our area. This analysis describes the findings of the MIRED_Uy study (measuring radiation in digestive endoscopy in Uruguay). Objective. To determine radiation exposure received by patients, physicians and assistants during ERCP. METHODS: Data were collected from 33 procedures conducted by four endoscopists, supported by endoscopy assistants. All staff took basic radiation-protection measures. The magnitudes measured were the kerma area product (KAP) for the patient and the effective dose (E) and the equivalent doses in hand (HM) and lens of the eyes (HC) for the operators. RESULTS: Mean value for PKA was 24 Gy.cm2 (range: 0.04-71) equivalent to 312 chest x-rays. The mean fluoroscopy time was 2.3 minutes (range: 0.45 a 5.70 minutes). The E mean per procedure was 3.69, 5.14 y 3.69 muSv, for physician, first and second assistant respectively. The dose in hand for the physician was 19.4 muSv and the dose in lens was 7.94 muSv. CONCLUSIONS: The first results of measuring ERCP radiation doses in Uruguay are presented These procedures expose the patient and staff to measurable radiation doses, which should be taken into account to minimize their risks.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica/normas , Fluoroscopia/normas , Exposição Ocupacional/normas , Doses de Radiação , Monitoramento de Radiação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar , Pessoa de Meia-Idade , Segurança do Paciente , Proteção Radiológica , Valores de Referência , Fatores de Tempo , UruguaiRESUMO
BACKGROUND: The ERCP procedure requires the use of fluoroscopy with the subsequent exposure to ionizing radiation. The doses received by patients, physicians and assistants in the endoscopy have never been recorded in our area. This analysis describes the findings of the MIRED_Uy study (measuring radiation in digestive endoscopy in Uruguay). Objective. To determine radiation exposure received by patients, physicians and assistants during ERCP. METHODS: Data were collected from 33 procedures conducted by four endoscopists, supported by endoscopy assistants. All staff took basic radiation-protection measures. The magnitudes measured were the kerma area product (KAP) for the patient and the effective dose (E) and the equivalent doses in hand (HM) and lens of the eyes (HC) for the operators. RESULTS: Mean value for PKA was 24 Gy.cm2 (range: 0.04-71) equivalent to 312 chest x-rays. The mean fluoroscopy time was 2.3 minutes (range: 0.45 a 5.70 minutes). The E mean per procedure was 3.69, 5.14 y 3.69 muSv, for physician, first and second assistant respectively. The dose in hand for the physician was 19.4 muSv and the dose in lens was 7.94 muSv. CONCLUSIONS: The first results of measuring ERCP radiation doses in Uruguay are presented These procedures expose the patient and staff to measurable radiation doses, which should be taken into account to minimize their risks.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Fluoroscopia/normas , Monitoramento de Radiação , Exposição Ocupacional/normas , Colangiopancreatografia Retrógrada Endoscópica/normas , Proteção Radiológica , Valores de Referência , Fatores de Tempo , Uruguai , Segurança do Paciente , Corpo Clínico HospitalarRESUMO
BACKGROUND: The ERCP procedure requires the use of fluoroscopy with the subsequent exposure to ionizing radiation. The doses received by patients, physicians and assistants in the endoscopy have never been recorded in our area. This analysis describes the findings of the MIRED_Uy study (measuring radiation in digestive endoscopy in Uruguay). Objective. To determine radiation exposure received by patients, physicians and assistants during ERCP. METHODS: Data were collected from 33 procedures conducted by four endoscopists, supported by endoscopy assistants. All staff took basic radiation-protection measures. The magnitudes measured were the kerma area product (KAP) for the patient and the effective dose (E) and the equivalent doses in hand (HM) and lens of the eyes (HC) for the operators. RESULTS: Mean value for PKA was 24 Gy.cm2 (range: 0.04-71) equivalent to 312 chest x-rays. The mean fluoroscopy time was 2.3 minutes (range: 0.45 a 5.70 minutes). The E mean per procedure was 3.69, 5.14 y 3.69 muSv, for physician, first and second assistant respectively. The dose in hand for the physician was 19.4 muSv and the dose in lens was 7.94 muSv. CONCLUSIONS: The first results of measuring ERCP radiation doses in Uruguay are presented These procedures expose the patient and staff to measurable radiation doses, which should be taken into account to minimize their risks.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Endoscopia por Cápsula/instrumentação , Endoscopia por Cápsula/métodos , Endoscopia do Sistema Digestório/métodos , Colonoscopia/métodos , Doenças do Colo/diagnóstico , Doenças do Colo , Esôfago de Barrett/diagnóstico , Pólipos/diagnóstico , Pólipos , Sensibilidade e Especificidade , UruguaiAssuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Endoscopia do Sistema Digestório/métodos , Endoscopia por Cápsula/instrumentação , Endoscopia por Cápsula/métodos , Colonoscopia/métodos , Doenças do Colo/diagnóstico , Doenças do Colo/diagnóstico por imagem , Pólipos/diagnóstico , Pólipos/diagnóstico por imagem , Esôfago de Barrett/diagnóstico , Sensibilidade e Especificidade , UruguaiRESUMO
Presentamos las historias clínicas de cuatro pacientes, operados tres de ellos por litiasis biliar por otros cirujanos. A los dos que tenían cálculos coledocianos se les efectuó coledocoduodenostomía, años después desarrolla cáncer de colédoco uno y del duodeno el otro y el paciente al que se le ligó el colédoco le practicamos una hepatoyeyunostomía y reingresó al año con un cáncer de cabeza de pancreas que obviamente no dió ictericia. Un cuarto enfermo cuyo primer cirujano sospechó un cáncer de páncreas y le hizo una colecistoyeyunostomía sobre asa no desfuncionalizada resultó no tener nada en la papila y se halló un cáncer superficial de vesícula después de la derivación de su anastomosis yatrogénica
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias dos Ductos Biliares/cirurgia , Neoplasias Duodenais/cirurgia , Neoplasias da Vesícula Biliar/cirurgia , Neoplasias Pancreáticas , Anastomose Cirúrgica/efeitos adversos , Colecistectomia/efeitos adversos , ColedocostomiaRESUMO
Se presenta la experiencia inicial del drenaje endoscópico de la vía biliar (DBE) utilizando 2 técnicas: DBE externo con sonda nasobiliar en 2 pacientes y DBE interno o endoprótesis en 3 casos. Las indicaciones fueron, colangitis por litiasis en los 2 casos de DBE externo. El DBE interno se utilizó en un caso de estenosis de vía biliar por neoplasma de páncreas, otro de estenosis de vía biliar por neoplasma de vesícula y un caso de litiasis coledociana con contraindicaciones quirúrgicas. Los resultados iniciales son muy buenos para el DBE externo en las colangitis y DBE interno por neoplasma. Deben evaluarse los resultados a largo plazo de este último grupo
Assuntos
Idoso , Humanos , Sistema Biliar/patologia , Drenagem , Endoscopia , DrenagemRESUMO
Se presenta un caso de hemorragia digestiva de origen oculto por malformación vascular de yeyuno alto. Se realizan consideraciones patológicas sobre la entidad y se describen los métodos de diagnóstico pre e intraoperatorio. Se concluye que la enteroscopía pre e intraoperatoria es el procedimiento de elección en el manejo de las mismas
Assuntos
Idoso , Humanos , Feminino , Endoscopia , Hemorragia Gastrointestinal , Jejuno , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/cirurgiaRESUMO
Se presenta una observación de una paciente portadora de poliposis juvenil múltiple, lo que determinó invaginación ileocecocólica. El exámen histológico demostró la coexistencia de pólipos juveniles y adenomatosos. Se hace una revisión de la frecuencia con que esta patología determina complicaciones quirúrgicas y se insiste en el interés del examen histológico de la poliposis juvenil, dada la posibilidad de asociar lesiones adenomatosas
