Manejo quirúrgico de la Coledocolitiasis gigante

Abstract

We performed a descriptive assessment for to determine which is the managing of the giant common bile duct stone in the General Surgery De parment of the National Hospital P.N.P “Luis N. Sáenz”.The obtained population was 26 clinical histories of the total of patients, 9 (35 %) was of masculine sex, 17 (65 %) was of feminine sex with an average age of 69 years (37 - 92).Clinical picture of 19 (73 %) they presented abdominal pain, 15 (57 %) dyspepsia to fats, and only 9 (34 %) presented jaundice. 17 (66 %) they had a previous cholecystectomy the laboratory analyses it was of FA 947 U/l, the GGTP 426 U/l (range of 206 - 739 DS 533) and elevated billirubin. There realized a total of 56 CPRE all with papilotomy, 89 % I realize the extraction of biliary stones with litotripsia and to 11 % by means of catheter ball, prostheses were placed. 14 biliodigestive derivations were
realized with a morbidity of 28 %, biliary water-pipe in 4 cases; 71 % was laparoscópyc and 29 conventional %. The predictores of giant common bile duct stone have better results combining the epidemiological criteria, laboratorial, clinical and confi rmed with magnetic resonance, these are of usefulness to determine the best strategy.