Encuesta nacional sobre tratamiento quirúrgico de patología del hígado, vía biliar y páncreas

Background: Chile has a high incidence of cholelithiasis and associated complications, that usually require surgical treatment. Aim: Lo carry out an enquiry about biliary diseases and their surgical treatment in public and private surgical services in Chile. Material and Methods: An enquiry about liver and biliary diseases and their treatment was designed and sent by electronic mail to 35 surgical services. Results: Lhe enquiry was answeredby 17 services. A total of 9.505 cholecystectomies were reported. Between21 and 98 percent of the procedures were laparoscopic. Iatrogenic lesions of the biliary tree were reported in 0.3 percent of the procedures. Choledocolithiasis was found associated to cholelithiasis in 0 to 21 percent of procedures. However, the use of intraoperative cholangiography was incidental. Lhe incidence of gallbladder cancer in cholecystectomies for cholelithiasis fluctuated between 0.2 and 8.9 percent. Liver metastases derived from colorectal cancer were the most common liver tumor operated. Hydatidosis was more common in southern Chile. Pancreatic excision was almost exclusively performed in Metropolitan Santiago. Conclusions: This information will allow the establishment of information and collaboration channels among the surgical services throughout Chile. Se trata de una encuesta realizada con el objeto de conocer la frecuencia e incidencia de las principales patologias y tecnicas quirurgicas de la esfera hepato-bilio-pancreatica atendida en centros de salud publicos y privados del pais durante el ano 2007. La encuesta fue respondida por 17 instituciones nacionales. Entre los resultados resaltan el total de colecistectomias reportadas de 9.505, de las cuales entre un 21 y 98 por ciento son realizadas por via laparoscopica. Lesiones iatrogenicas de via biliar ocurrieron dentro de un rango de 0 a 1,5 por ciento, con una mediana de 0,3 por ciento. La frecuencia de coledocolitiasis asociada a la colelitiasis ocurrio entre un 0 a 21 por ciento, aunque el empleo de colangiografia intraoperatoria es en general de ocurrencia incidental. La incidencia de cancer vesicular en colecistectomias por colelitiasis es claramente distinta segun se trate de instituciones de centro-norte y sur del pais, con incidencias que varian entre 0,2 y 8,9 por ciento. Las metastasis hepaticas operadas son principalmente de origen colorrectal, y son los tumores hepaticos mas frecuentemente tratados. La hidatidosis hepatica manifiesta en esta encuesta su conocida distribucion geografica, siendo mas frecuentemente tratada en los centros del sur del pais. La cirugia pancreatica resectiva tiende a estar concentrada en las instituciones de la region metropolitana.