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1.
Sao Paulo Med J ; 139(4): 351-363, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34161522

RESUMEN

BACKGROUND: The role of transient obstructive cholestasis on liver histology remains undetermined. OBJECTIVE: To investigate whether transient cholestasis impairs liver histology. DESIGN AND SETTING: Cross-sectional study at a public university hospital (UNICAMP), Brazil. METHODS: 169 individuals undergoing cholecystectomy, with or without cholestasis. were enrolled. Histopathological findings were correlated with clinical and biochemical characteristics. RESULTS: Biliary hepatopathy was more frequent in individuals with resolved cholestasis than in those with active obstruction or no jaundice (P < 0.01), as also were fibrosis and ductular proliferation (P = 0.02). Cholestasis was commoner in individuals with resolved obstruction than in those with no history (P < 0.01) or active cholestasis (P < 0.05). Biliary hepatopathy was associated with longer duration of cholestasis (P < 0.001) and higher bilirubin levels (P = 0.02) in individuals with active obstruction; with lower body mass index (P = 0.02) and longer cholestasis (P < 0.001) in individuals with resolved obstruction; and with longer cholestasis (P < 0.001) and longer interval between endoscopic retrograde cholangiopancreatography and surgery (P = 0.03) overall. In individuals with active obstruction, duration of cholestasis (R = 0.7; P < 0.001) and bilirubin levels (R = 0.6; P = 0.004) were independently correlated with cholestasis severity. Duration of cholestasis (R = 0.7; P < 0.001) was independently correlated with ductular proliferation severity. CONCLUSIONS: Transient cholestasis was associated with significant histopathological changes, even after its resolution. Longer duration of obstruction correlated with greater severity of histopathological changes, especially cholestasis and ductular proliferation. This emphasizes the need for early treatment of obstructive cholestasis.


Asunto(s)
Colestasis , Hígado , Brasil/epidemiología , Colangiopancreatografia Retrógrada Endoscópica , Colestasis/etiología , Estudios Transversales , Humanos
2.
Nutr Hosp ; 36(3): 743-747, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-30985185

RESUMEN

INTRODUCTION: Case report: we present the case of a 44-year-old male who presented with uncontrollable diarrhea, severe protein-calorie malnutrition and multiple vitamin deficiencies, along with peripheral neuropathy ten years after classic biliopancreatic diversion (BPD). He underwent nutritional support and had the surgery converted to a Roux-en-Y gastric bypass, with an uneventful outcome. The histopathology of the resected bowel revealed lipofuscinosis of the muscular layer compatible with brown bowel syndrome. Discussion: brown bowel syndrome is a rare complication of malnutrition that can be observed after BPD. It is associated with vitamin E deficiency. After recovery with nutritional support, a reoperation that elongates the common channel, and thus minimizes the degree of malabsorption, should be indicated in these cases.


INTRODUCCIÓN: Caso clínico: presentamos el caso de un paciente varón de 44 años que presentó diarrea incontrolable, desnutrición proteica-calórica severa y deficiencias de múltiples vitaminas, junto con neuropatía periférica diez años después de derivación biliopancreatica clásica (DBP). Se sometió a soporte nutricional y la cirugía se convirtió en un bypass gástrico en Y de Roux, con un resultado sin complicaciones. La histopatología del intestino resecado reveló una lipofuscinosis de la capa muscular compatible con el síndrome del intestino marrón. Discusión: el síndrome de intestino marrón es una complicación rara de la desnutrición que se puede observar después de la DBP. Se asocia a deficiencia de vitamina E. Después de la recuperación con soporte nutricional, se debe indicar una reoperación que alargue el canal común y, por lo tanto, minimice el grado de malabsorción en estos casos.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Enfermedades Gastrointestinales/etiología , Enfermedades Gastrointestinales/terapia , Desnutrición/etiología , Desnutrición/terapia , Complicaciones Posoperatorias/terapia , Adulto , Humanos , Masculino , Apoyo Nutricional , Obesidad Mórbida/cirugía , Deficiencia de Vitamina E/etiología , Deficiencia de Vitamina E/terapia
3.
Arq Gastroenterol ; 56(1): 15-21, 2019 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-31141062

RESUMEN

BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.


Asunto(s)
Glucemia/metabolismo , Derivación Gástrica/métodos , Obesidad Mórbida/cirugía , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de Tiempo , Pérdida de Peso
4.
Sao Paulo Med J ; 137(6): 491-497, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-32159634

RESUMEN

BACKGROUND: Obstructive jaundice may lead to ominous complications and requires complex diagnostic evaluations and therapies that are not widely available. OBJECTIVE: To analyze the epidemiological profile, referral routes and diagnostic accuracy at admittance of cases of acute cholangitis among patients with obstructive jaundice treated at a referral unit. DESIGN AND SETTING: Cross-sectional study at a tertiary-level university hospital. METHODS: Patients with obstructive jaundice who were treated by means of endoscopic retrograde cholangiopancreatography, resection and/or surgical biliary drainage were evaluated. The main variables analyzed were epidemiological data, referral route, bilirubin levels and time elapsed between symptom onset and admittance and diagnosing of acute cholangitis at the referral unit. The accuracy of the clinical diagnosis of acute cholangitis was compared with a retrospective analysis on the medical records in accordance with the Tokyo criteria. RESULTS: Female patients predominated (58%), with an average age of 56 years. Acute cholangitis was detected in 9.9% of the individuals; application of the Tokyo criteria showed that the real prevalence was approximately 43%. The main referral route was direct contact (31.8%) and emergency care (29.7%); routing via official referral through the public healthcare system accounted for 17.6%, and internal referral from other specialties, 20%. The direct route with unofficial referral was the most important route for cases of neoplastic etiology (P < 0.01) and was the fastest route (P < 0.01). CONCLUSIONS: There is a deficiency in the official referral routes for patients with obstructive jaundice. The accuracy of the clinical diagnosis of acute cholangitis was poor. Wider dissemination of the Tokyo criteria is essential.


Asunto(s)
Colangitis/diagnóstico , Hospitales Universitarios , Ictericia Obstructiva/diagnóstico , Centros de Atención Terciaria , Enfermedad Aguda , Adulto , Anciano , Bilirrubina/análisis , Brasil/epidemiología , Colangiopancreatografia Retrógrada Endoscópica/estadística & datos numéricos , Colangitis/epidemiología , Colangitis/cirugía , Estudios Transversales , Exactitud de los Datos , Drenaje , Femenino , Humanos , Ictericia Obstructiva/epidemiología , Ictericia Obstructiva/cirugía , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud , Admisión del Paciente/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Sensibilidad y Especificidad , Tiempo de Tratamiento
5.
Arq Gastroenterol ; 55(4): 412-416, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30785528

RESUMEN

BACKGROUND: Cystic lesions of the pancreas represent a group of pancreatic diseases with great histological heterogeneity, varying from benign lesions, some of them with malignant potential, to overt malignant lesions. OBJECTIVE: To describe the cases of cystic lesions of the pancreas which underwent surgical intervention at a tertiary university hospital. METHODS: This is a retrospective population-based study (historical cohort) which was carried out enrolling individuals attended at the Outpatient service of Pancreas Surgery of the Hospital de Clínicas of Unicamp. The individuals underwent surgical procedures performed from January 2012 through December 2016. RESULTS: In the period evaluated, 39 cases of cystic lesions of the pancreas which underwent surgery were identified, 26 (66.6%) of which were female. The average age at diagnosis was 47.4±16.4 years (range, 18-73). In regards to symptoms, 35 (89.7%) were symptomatic. The average length of hospital stay was 10 days (range 4-76). Surgeries performed to treat the lesions depended on the localization and type of the lesions: cystojejunostomy (41%), distal pancreatectomy (36%), pancreaticoduodenectomy (15.4%), drainage of ruptured and/or infected pseudocyst (5.2%) and central pancreatectomy (2.6%). CONCLUSION: Cystic lesions of the pancreas are a group of lesions with a highly varying presentation and diagnostic approach and may require an also highly variable surgical treatment. An appropriate preoperative imaging diagnosis is essential for their management.


Asunto(s)
Neoplasias Pancreáticas/cirugía , Seudoquiste Pancreático/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pancreatectomía , Neoplasias Pancreáticas/diagnóstico por imagen , Seudoquiste Pancreático/diagnóstico por imagen , Pancreaticoduodenectomía , Estudios Retrospectivos , Adulto Joven
6.
J Surg Case Rep ; 2018(7): rjy177, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30046442

RESUMEN

An 69-year-old obese woman was submitted to an abdominoperineal resection (APR) with left side end colostomy to treat a synchronic sigmoid and middle rectum cancer. Six months after APR, she develop a PH with a progressive increase of the size. The patient refused the surgical indication. Thirteen years after APR she presenting with abdominal pain, hematemesis, bilious vomiting and non-functioning of the stoma in the last 2 days. She had a distended and painful abdomen without signs of peritoneal irritation and a large incarcerated PH. CT showed a PH with incarcerated gastric herniation. Endoscopy showed a 4 cm ulcerated lesion in the lesser curvature of the stomach whose posteriorly histopathological study revealed that it was an ischemic ulcer. She was submitted a correction of PH using an onlay polypropylene mesh put around of the previous stoma. The patient has an uneventful recovery and was discharged 3 days later.

7.
São Paulo med. j ; São Paulo med. j;139(4): 351-363, Jul.-Aug. 2021. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1290251

RESUMEN

ABSTRACT BACKGROUND: The role of transient obstructive cholestasis on liver histology remains undetermined. OBJECTIVE: To investigate whether transient cholestasis impairs liver histology. DESIGN AND SETTING: Cross-sectional study at a public university hospital (UNICAMP), Brazil. METHODS: 169 individuals undergoing cholecystectomy, with or without cholestasis. were enrolled. Histopathological findings were correlated with clinical and biochemical characteristics. RESULTS: Biliary hepatopathy was more frequent in individuals with resolved cholestasis than in those with active obstruction or no jaundice (P < 0.01), as also were fibrosis and ductular proliferation (P = 0.02). Cholestasis was commoner in individuals with resolved obstruction than in those with no history (P < 0.01) or active cholestasis (P < 0.05). Biliary hepatopathy was associated with longer duration of cholestasis (P < 0.001) and higher bilirubin levels (P = 0.02) in individuals with active obstruction; with lower body mass index (P = 0.02) and longer cholestasis (P < 0.001) in individuals with resolved obstruction; and with longer cholestasis (P < 0.001) and longer interval between endoscopic retrograde cholangiopancreatography and surgery (P = 0.03) overall. In individuals with active obstruction, duration of cholestasis (R = 0.7; P < 0.001) and bilirubin levels (R = 0.6; P = 0.004) were independently correlated with cholestasis severity. Duration of cholestasis (R = 0.7; P < 0.001) was independently correlated with ductular proliferation severity. CONCLUSIONS: Transient cholestasis was associated with significant histopathological changes, even after its resolution. Longer duration of obstruction correlated with greater severity of histopathological changes, especially cholestasis and ductular proliferation. This emphasizes the need for early treatment of obstructive cholestasis.


Asunto(s)
Humanos , Colestasis/etiología , Hígado , Brasil/epidemiología , Estudios Transversales , Colangiopancreatografia Retrógrada Endoscópica
8.
Nutr. hosp ; 36(3): 743-747, mayo-jun. 2019. tab, ilus
Artículo en Inglés | IBECS (España) | ID: ibc-184577

RESUMEN

Case report: we present the case of a 44-year-old male who presented with uncontrollable diarrhea, severe protein-calorie malnutrition and multiple vitamin deficiencies, along with peripheral neuropathy ten years after classic biliopancreatic diversion (BPD). He underwent nutritional support and had the surgery converted to a Roux-en-Y gastric bypass, with an uneventful outcome. The histopathology of the resected bowel revealed lipofuscinosis of the muscular layer compatible with brown bowel syndrome. Discussion: brown bowel syndrome is a rare complication of malnutrition that can be observed after BPD. It is associated with vitamin E deficiency. After recovery with nutritional support, a reoperation that elongates the common channel, and thus minimizes the degree of malabsorption, should be indicated in these cases


Caso clínico: presentamos el caso de un paciente varón de 44 años que presentó diarrea incontrolable, desnutrición proteica-calórica severa y deficiencias de múltiples vitaminas, junto con neuropatía periférica diez años después de derivación biliopancreatica clásica (DBP). Se sometió a soporte nutricional y la cirugía se convirtió en un bypass gástrico en Y de Roux, con un resultado sin complicaciones. La histopatología del intestino resecado reveló una lipofuscinosis de la capa muscular compatible con el síndrome del intestino marrón. Discusión: el síndrome de intestino marrón es una complicación rara de la desnutrición que se puede observar después de la DBP. Se asocia a deficiencia de vitamina E. Después de la recuperación con soporte nutricional, se debe indicar una reoperación que alargue el canal común y, por lo tanto, minimice el grado de malabsorción en estos casos


Asunto(s)
Humanos , Masculino , Adulto , Cirugía Bariátrica/efectos adversos , Desnutrición Proteico-Calórica/complicaciones , Desnutrición/complicaciones , Síndromes de Malabsorción/complicaciones , Apoyo Nutricional , Deficiencia de Vitamina E/complicaciones , Enfermedades Intestinales/etiología , Intestino Delgado/diagnóstico por imagen , Intestino Delgado/patología , Trastornos de la Pigmentación/complicaciones , Enfermedades Intestinales/patología , Enfermedades Intestinales/complicaciones
9.
Arq. gastroenterol ; Arq. gastroenterol;56(1): 15-21, Jan.-Mar. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1001330

RESUMEN

ABSTRACT BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.


RESUMO CONTEXTO: A influência da colocação de bandas sobre os resultados do bypass gástrico de anastomose única (BGAU) não foi profundamente estudada. OBJETIVO: Comparar a perda precoce de peso e os parâmetros do metabolismo da glicose após bypass gástrico de anastomose única (BGAU) com e sem anel. MÉTODOS: Estudo prospectivo randomizado que avaliou 20 obesos mórbidos submetidos ao BGAU com e sem anel e acompanhados por três meses. A perda de peso (percentual de perda do excesso de peso - %PEP e percentual de perda de peso - %PP) e parâmetros do metabolismo da glicose (glicemia, insulina e modelo homeostático de avaliação - HOMA) foram comparados. RESULTADOS: O grupo com anel apresentou %PEP significativamente maior em um mês (29,6±5,5% vs 17,2±3,4%; P<0,0001) e dois meses após a cirurgia (46±7% vs 34,2±9%; P=0,004544), bem como %PP significativamente maior em um mês (9,7±1,1% vs 5,8±0,8%; P<0,0001), dois meses (15±1,4% vs 11,5±2,1; P=0,000248) e três meses (18,8±1,8% vs 15,7±3,2%; P=0,016637). Aos três meses, o BGAU com anel resultou em reduções significativas de insulina (14,4±4,3 vs 7,6±1,9; P=0,00044) e HOMA (3,1±1,1 vs 1,5±0,4; P=0,00044), enquanto o BGAU sem anel também levou a reduções significativas de insulina (14,8±7,6 vs 7,8±3,1; P=0,006) e HOMA (3,2±1,9 vs 1,6±0,8; P=0,0041). A variação percentual de HOMA não diferiu significativamente entre BGAU com bandas ou sem anel (P=0,62414); no geral, a variação percentual do HOMA não foi correlacionada com %PEP (P=0,96988) ou %PP (P=0,82299). CONCLUSÃO: O BGAU com anel levou a uma maior perda de peso precoce do que a técnica padrão. O BGAU com ou sem anel levou à melhora precoce na resistência à insulina, independentemente da perda de peso.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Glucemia/metabolismo , Obesidad Mórbida/cirugía , Derivación Gástrica/métodos , Factores de Tiempo , Pérdida de Peso , Estudios Prospectivos
10.
São Paulo med. j ; São Paulo med. j;137(6): 491-497, Nov.-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1094526

RESUMEN

ABSTRACT BACKGROUND: Obstructive jaundice may lead to ominous complications and requires complex diagnostic evaluations and therapies that are not widely available. OBJECTIVE: To analyze the epidemiological profile, referral routes and diagnostic accuracy at admittance of cases of acute cholangitis among patients with obstructive jaundice treated at a referral unit. DESIGN AND SETTING: Cross-sectional study at a tertiary-level university hospital. METHODS: Patients with obstructive jaundice who were treated by means of endoscopic retrograde cholangiopancreatography, resection and/or surgical biliary drainage were evaluated. The main variables analyzed were epidemiological data, referral route, bilirubin levels and time elapsed between symptom onset and admittance and diagnosing of acute cholangitis at the referral unit. The accuracy of the clinical diagnosis of acute cholangitis was compared with a retrospective analysis on the medical records in accordance with the Tokyo criteria. RESULTS: Female patients predominated (58%), with an average age of 56 years. Acute cholangitis was detected in 9.9% of the individuals; application of the Tokyo criteria showed that the real prevalence was approximately 43%. The main referral route was direct contact (31.8%) and emergency care (29.7%); routing via official referral through the public healthcare system accounted for 17.6%, and internal referral from other specialties, 20%. The direct route with unofficial referral was the most important route for cases of neoplastic etiology (P < 0.01) and was the fastest route (P < 0.01). CONCLUSIONS: There is a deficiency in the official referral routes for patients with obstructive jaundice. The accuracy of the clinical diagnosis of acute cholangitis was poor. Wider dissemination of the Tokyo criteria is essential.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Colangitis/diagnóstico , Ictericia Obstructiva/diagnóstico , Centros de Atención Terciaria , Hospitales Universitarios , Admisión del Paciente/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Bilirrubina/análisis , Brasil/epidemiología , Aceptación de la Atención de Salud , Drenaje , Colangitis/cirugía , Colangitis/epidemiología , Enfermedad Aguda , Estudios Transversales , Estudios Retrospectivos , Sensibilidad y Especificidad , Colangiopancreatografia Retrógrada Endoscópica/estadística & datos numéricos , Ictericia Obstructiva/cirugía , Ictericia Obstructiva/epidemiología , Exactitud de los Datos
11.
Arq. gastroenterol ; Arq. gastroenterol;55(4): 412-416, Oct.-Dec. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-983838

RESUMEN

ABSTRACT BACKGROUND: Cystic lesions of the pancreas represent a group of pancreatic diseases with great histological heterogeneity, varying from benign lesions, some of them with malignant potential, to overt malignant lesions. OBJECTIVE: To describe the cases of cystic lesions of the pancreas which underwent surgical intervention at a tertiary university hospital. METHODS: This is a retrospective population-based study (historical cohort) which was carried out enrolling individuals attended at the Outpatient service of Pancreas Surgery of the Hospital de Clínicas of Unicamp. The individuals underwent surgical procedures performed from January 2012 through December 2016. RESULTS: In the period evaluated, 39 cases of cystic lesions of the pancreas which underwent surgery were identified, 26 (66.6%) of which were female. The average age at diagnosis was 47.4±16.4 years (range, 18-73). In regards to symptoms, 35 (89.7%) were symptomatic. The average length of hospital stay was 10 days (range 4-76). Surgeries performed to treat the lesions depended on the localization and type of the lesions: cystojejunostomy (41%), distal pancreatectomy (36%), pancreaticoduodenectomy (15.4%), drainage of ruptured and/or infected pseudocyst (5.2%) and central pancreatectomy (2.6%). CONCLUSION: Cystic lesions of the pancreas are a group of lesions with a highly varying presentation and diagnostic approach and may require an also highly variable surgical treatment. An appropriate preoperative imaging diagnosis is essential for their management.


RESUMO CONTEXTO: As lesões císticas do pâncreas representam um grupo de doenças pancreáticas com grande heterogeneidade histológica, variando desde lesões benignas, algumas com potencial pré-maligno, até outras degeneradas para formas malignas. OBJETIVO: Descrever os casos de LCPs submetidos à intervenção cirúrgica em um hospital universitário terciário. MÉTODOS: Trata-se de um estudo retrospectivo populacional (coorte histórica) realizado com a participação de indivíduos atendidos no Ambulatório de Cirurgia do Pâncreas do Hospital de Clínicas da Unicamp. Os indivíduos foram submetidos a procedimentos cirúrgicos realizados no período de janeiro de 2012 a dezembro de 2016. RESULTADOS: No período avaliado, foram identificados 39 casos de lesões císticas do pâncreas operados, sendo 26 (66,6%) do sexo feminino. A idade média no diagnóstico foi de 47,4±16,4 anos. Em relação aos sintomas, 35 (89,7%) eram sintomáticos. O tempo médio de internação foi de 10 dias (variação de 4-76). As cirurgias realizadas para o tratamento das lesões dependeram da localização e do tipo das lesões: derivação pseudocisto-jejunal (41%), pancreatectomia distal (36%), pancreaticoduodenectomia (15,4%), drenagem de pseudocistos rotos e/ou infectados (5,2%) e pancreatectomia central (2,6%). CONCLUSÃO: As lesões císticas do pâncreas são um grupo de lesões cuja apresentação e abordagem diagnóstica são altamente heterogêneas e que podem requerer um tratamento cirúrgico altamente complexo e variável. Um diagnóstico pré-operatório adequado é essencial para definir o seu tratamento.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Hepatitis C Crónica/diagnóstico , Hepatitis C Crónica/economía , Calidad de Vida , Factores Socioeconómicos , Brasil/epidemiología , Actividades Cotidianas , Comorbilidad , Salud Pública , Métodos Epidemiológicos , Costos de la Atención en Salud , Hepacivirus , Hepatitis C Crónica/epidemiología , Persona de Mediana Edad , Programas Nacionales de Salud/economía
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