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dc.contributor.advisorRuíz Steimberg, Jaime Enrique 
dc.creatorChinchilla Hermida, Paola Andrea 
dc.creatorBaquero Zamarra, David Ricardo 
dc.date.accessioned2016-10-21T15:33:44Z
dc.date.available2016-10-21T15:33:44Z
dc.date.created2016-10-03
dc.date.issued2016
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/12471
dc.descriptionIntroducción: la colecistectomía laparoscópica es la técnica de elección en pacientes con indicación de extracción quirúrgica de la vesícula; sin embargo, en promedio 20% de éstos requieren conversión a técnica abierta. En este estudio se evaluaron los factores de riesgo preoperatorios para conversión en colecistectomía laparoscópica de urgencia. Metodología: se realizó un estudio de casos y controles no pareado. Se obtuvo información sociodemográfica y de variables de interés de los registros de historias clínicas de pacientes operados entre el 2013 y 2016. Se identificaron los motivos de conversión de técnica quirúrgica. Se caracterizó la población de estudio y se estimaron asociaciones según la naturaleza de las variables. Mediante un análisis de regresión logística se ajustaron posibles variables de confusión. Resultados: se analizaron los datos de 444 pacientes (111 casos y 333 controles). La causa de conversión más frecuente fue la dificultad técnica (50,5%). Se encontró que la mayor edad, el sexo masculino, el antecedente de cirugía abierta en hemiabdomen superior, el signo de Murphy clínico positivo, la dilatación de la vía biliar, la leucocitosis y la mayor experiencia del cirujano, fueron factores de riesgo para conversión. Se encontró un área bajo la curva ROC= 0,743 (IC95% 0,692–0,794, p= <0,001). Discusión: existen unos factores que se asocian a mayor riesgo de conversión en colecistectomía laparoscópica. La mayoría se relacionan con un proceso inflamatorio más severo, por lo que se debe evitar la prolongación del tiempo de espera entre el inicio de los síntomas y la extirpación quirúrgica de la vesícula.
dc.description.abstractIntroduction: laparoscopic cholecystectomy is the election technique for patients with indication for gallbladder extraction. Nevertheless, near 20% of them require conversion to open surgery. In this study we evaluated preoperative risk factors for conversion in patients carried to emergency laparoscopic cholecystectomy. Metodology: a case-control unmatched study was conducted. Sociodemographic information and other interest variables were took from medical records of patients carried to surgery from 2013 to 2016. Conversion reasons were identified and study population was characterized. Correlations test were established and logistic regression was performed for evaluating the role of confounding factors. Results: we analized medical records from 444 patients (111 cases and 333 controls). Commonest conversion reason was technical difficulty (50, 5%). Older age, male sex, previous open upper abdominal surgery, Murphy sign, bile duct dilation, total white cell count &gt; 12. 000/mm3 and more experienced surgeon, were all risk factors for conversion to open surgery. Area under COR curve was 0. 743 (CI95% 0. 692–0. 794, p= &lt; 0. 001). Discussion: some factors increase the risk for conversion to open surgery in laparoscopic cholecystectomy. Most of them are related to an advanced gallbladder inflammation process, so extending time from symptoms beginning to surgical extraction of this organ, must be avoided.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectcolecistectomía laparoscópica
dc.subjectconversión a cirugía abierta
dc.subjectfactores de riesgo
dc.subject.ddcIncidencia & prevención de la enfermedad 
dc.subject.lembEpidemiología
dc.titleFactores de riesgo preoperatorios asociados a conversión a técnica abierta en colecistectomía laparoscópica de urgencia
dc.typebachelorThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.publisher.departmentFacultad de medicina
dc.subject.keywordcholecystectomy
dc.subject.keywordlaparoscopic
dc.subject.keywordconversion to open surgery
dc.subject.keywordrisk factors
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsEpidemiología
dc.subject.decsColecistectomía
dc.subject.decsMedicina de emergencia
dc.subject.decsPeriodo preoperatorio
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.


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