Colangiopancreatografia retrograda endoscópica en pacientes con patología biliopancreática: Experiencia en 322 casos

Introduccion: La Colangiopancreatografia retrograda endoscopica (CPRE) es el procedimiento de eleccion actual en la patologia biliopancreatica, principalmente en casos de obstruccion biliar y colangitis, jugando un rol importante en el tratamiento de las estenosis benignas y malignas de las vias biliares. Objetivo: Presentar la experiencia de la Unidad de Gastroenterologia del Hospital Central Universitario Antonio Maria Pineda en CPRE en pacientes con patologia bilio-pancreatica. Material y metodos: Se realizo un estudio descriptivo retrospectivo mediante la revision de historias clinicas de pacientes con patologia biliopancreatica que ameritaron una CPRE en el Servicio de Gastroenterologia del Hospital Central Universitario Antonio Maria Pineda durante 2004- 2007, excluyendose las historias incompletas para la informacion requerida. Resultados: Se revisaron 322 casos encontrandose que 69% pertenecia al sexo femenino. El grupo etario predominante estuvo comprendido entre 30 y 42 anos. La indicacion de la CPRE fue Coledocolitiasis en 61% seguida de neoplasias bilio-pancreaticas en 17%. Los hallazgos ecograficos mas frecuentes previos a la CPRE fueron la dilatacion de vias biliares en 44% y coledocolitiasis en 19%. Los hallazgos mas frecuentes encontrados en la CPRE fueron Odditis en 23%, calculos en via biliar en 21% y dilatacion coledociana en 15%. Se realizaron 202 papiloesfinterotomias, se colocaron 58 protesis y realizaron 40 dilataciones con balon. El 88% de las CPRE fue exitoso siendo la principal complicacion la hemorragia leve en 9%. Conclusiones: la CPRE es un procedimiento seguro y efectivo en el tratamiento y diagnostico de algunas patologias del arbol hepatobiliar, con resultados de morbilidad comparables a los entregados por las series internacionales.(AU) Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) is currently the first choice of treatment for biliopancreatic pathologies, mostly in cases of biliary obstruction and cholangitis, playing a leading role in the treatment of either benign or malign strictures of the biliary tree. Objectives: to present the experience at the Gastroenterology Department of the Antonio Maria Pineda Central University Hospital in patients undergoing ERCP for a biliopancreatic pathology. Materials and methods: a descriptive, retrospective study was conducted by review of clinical histories of patients with biliopancreatic pathology requiring the performance of an ERCP between years 2004-2007, excluding clinical histories with incomplete data. Results: overall, 322 histories were reviewed, 69% of the patients were female and a predominance of subjects aged 30-42 was found. The most frequent indication for ERCP was choledocolithiasis (61%), followed by biliopancreatic neoplasms (17%). The most common echographic findings previous to ERCP were dilation of the biliary tree in 44% and choledocolithiasis in 19% of the cases. Findings on ERCP were mostly odditis (23%), gallstones (21%) and choledocian dilation (16%). 202 papillotomies were performed, 58 prostheses were implanted and 40 balloon dilations were performed. Eighty-eight percent of the ERCPs were successful, with mild bleeding as the most frequent complication (9%). Conclusions: ERCP is both and effective and safe procedure for the treatment and diagnosis of some pathologies of the hepatobiliary tree, with morbidity results matching those seen in international series.(AU)