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Factores de riesgo de fuga biliar en pacientes sometidos a colecistectomía subtotal como procedimiento de rescate ante una colecistectomía difícil: casos y controles en una cohorte retrospectiva

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dc.contributor.advisorRamírez Giraldo, Camilo
dc.contributor.advisorIsaza Restrepo, Andrés
dc.creatorVillamizar Quiroga, Natalia
dc.creator.degreeMagíster en Epidemiología
dc.creator.degreeLevelMaestría
dc.date.accessioned2024-12-09T20:35:02Z
dc.date.available2024-12-09T20:35:02Z
dc.date.created2024-08-22
dc.descriptionIntroducción: La colecistectomía subtotal es un procedimiento de rescate ante una colecistectomía difícil recurso que viene en aumento. La complicación más frecuente de la colecistectomía subtotal es la fuga biliar. Esta complicación aumenta la estancia hospitalaria, la necesidad de CPRE posoperatoria, las colecciones intraabdominales y los trastornos hidroelectrolíticos. Se han realizado pocos trabajos de investigación que indaguen sobre factores de riesgo de fuga biliar posoperatoria a colecistectomía subtotal. Materiales y métodos: Se realizó estudio secundario, de cohorte retrospectiva de seguimiento de pacientes llevados a colecistectomía subtotal desde 2014 hasta 2022. Se realizó modelo de regresión logística para identificar factores de riesgo para fuga biliar postoperatoria de colecistectomía subtotal . Resultados: Se incluyeron 395 casos de colecistectomías subtotales. La mayoría se realizaron laparoscópicamente (56.5%) y con técnica reconstitutiva (84.8%). La frecuencia de fuga biliar fue de 13.4%. Se encontró asociación entre la aparición de fuga biliar con el grosor de la pared de la vesícula biliar (p=0.042). La fuga biliar se asoció con prolongación de estancia hospitalaria (p=0.001), mayor requerimiento de CPRE posoperatoria para manejo de coledocolitiasis (p=0.007) y mayor riesgo de reintervención (p<0.001) , y presencia de complicaciones mayores (p< 0.001). Conclusión: Identificar los factores de riesgo de fuga biliar postoperatoria es primordial, ya que podría permitir intervención temprana o preventiva. Sin embargo, pocos estudios han estudiado estos factores. Nuestro estudio identificó que el grosor de la pared de la vesícula biliar aumenta el riesgo de fuga biliar.
dc.description.abstractIntroduction: Subtotal cholecystectomy is a rescue procedure for difficult cholecystectomy, and its use is increasing. The most common complication of subtotal cholecystectomy is bile leak. This complication increases hospital stay, the need for postoperative ERCP, intra-abdominal collections, and electrolyte disturbances. Few studies have investigated the risk factors for postoperative bile leak following subtotal cholecystectomy. Materials and Methods: A secondary study was conducted on a retrospective cohort of patients who underwent subtotal cholecystectomy from 2014 to 2022. A logistic regression model was used to identify risk factors for postoperative bile leak. Results: A total of 395 subtotal cholecystectomies were included, most of which were performed laparoscopically and with a reconstitutive technique. The frequency of bile leakage was 13.4%. An association was found between bile leak and gallbladder wall thickness (p=0.042). Bile leak was associated with prolonged hospital stay (p=0.001), increased need for postoperative ERCP for managing choledocholithiasis (p=0.007), higher risk of reoperation (p<0.001), and the presence of major complications (p< 0.001). Conclusion: Developing strategies to assess the risk of postoperative bile leak is crucial, as it could allow for early or preventive intervention. However, few studies have investigated the risk factors for bile leakage. Our study identified that gallbladder wall thickness increased the risk of bile leakage.
dc.format.extent68 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_44494
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/44494
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisherUniversidad CES. Facultad de Medicina
dc.publisher.departmentEscuela de Medicina y Ciencias de la Saludspa
dc.publisher.programMaestría en Epidemiologíaspa
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International*
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectColecistectomía laparoscópica
dc.subjectFístula biliar
dc.subjectComplicaciones posoperatorias
dc.subjectColecistitis
dc.subjectFactores de riesgo
dc.subject.keywordCholecystectomy
dc.subject.keywordLaparoscopic
dc.subject.keywordBiliary Fistula
dc.subject.keywordPostoperative Complications
dc.subject.keywordCholecystitis
dc.subject.keywordRisk Factors
dc.titleFactores de riesgo de fuga biliar en pacientes sometidos a colecistectomía subtotal como procedimiento de rescate ante una colecistectomía difícil: casos y controles en una cohorte retrospectiva
dc.title.TranslatedTitleRisk Factors for Bile Leak in Patients Undergoing Subtotal Cholecystectomy as a Bailout Procedure for Difficult Cholecystectomy: A Retrospective Cohort
dc.typemasterThesis
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaArtículo
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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Maestría en Epidemiología