Manejo y conducta actualizada de ictericia obstructiva
Management and updated behavior of obstructive jaundice
Palabras clave:
obstrucción biliar, coledocolitiasis, colangitis
Resumen
La obstrucción biliar puede ocurrir en cualquier lugar de la vía biliar desde canalículos biliares hasta la ampolla de váter y puede provocar complicaciones graves como disfunción hepática, insuficiencia renal, deficiencias nutricionales, problemas de sangrado e infecciones. Afecta a una gran parte de la población mundial, causando una importante morbilidad y mortalidad. La etiología más común de la obstrucción biliar es la coledocolitiasis o cálculos biliares, que causan bloqueo de la vía biliar extrahepática. La manifestación más grave de esto es el desarrollo de una infección en los conductos biliares llamada colangitis, que puede ser fatal sino se trata de inmediato. Se puede dividir principalmente como intrahepáticas y extrahepáticas, sin embargo la etiología intrahepática no la trataremos con detalle en este artículo pero podemos resumir que la colestasis intrahepática puede deberse a varios procesos patológicos, incluidas las hepatitis (infecciones virales, alcohol), lesión hepática inducida por fármacos (antibióticos, acetaminofén, antiepilépticos, antiarrítmicos), colangitis biliar primaria, colangitis esclerosante primaria, y enfermedades infiltrativas (sarcoidosis, tumores, abscesos y quistes).
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Citas
Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int. 2018 Feb;17(1):17-21.
Kruis T, Güse-Jaschuck S, Siegmund B, Adam T, Epple HJ. Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis. BMC Gastroenterol. 2020 Mar 12;20(1):65.
Center SA. Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract. 2009 May. 39(3):543-98.
Zhu AX, Hong TS, Hezel AF, Kooby DA. Current management of gallbladder carcinoma. Oncologist. 2010. 15(2):168-81.
O'Connell W, Shah J, Mitchell J, et al. Obstruction of the biliary and urinary system. Tech Vasc Interv Radiol. 2017 Dec. 20(4):288-93.
Williams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M. Guidelines on the management of common bile duct stones (CBDS). Gut 2008; 57: 1004-1021 [PMID: 18321943 DOI: 10.1136/gut.2007.121657
Schwartz SI. Gallbladder and extrahepatic biliary system. In: Schwartz SI, Lillehei RC, Shires GT, Spencer FC, Storer EH, editors. Principles of Surgery. Second Edition. New York: McGraw-Hill, 1974: 1221-1254 46
Kondo S, Isayama H, Akahane M, Toda N, Sasahira N, Nakai Y, Yamamoto N, Hirano K, Komatsu Y, Tada M, Yoshida H, Kawabe T, Ohtomo K, Omata M. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol 2005; 54: 271-275 [PMID: 15837409 DOI: 10.1016/ j.ejrad.2004.07.007].
Mather JH, Williams WR. Cholecystography: the results of 125 consecutive cases examined by the oral administration of the salt. Br Med J 1927; 1: 614-615 [PMID: 20773106].
Stott MA, Farrands PA, Guyer PB, Dewbury KC, Browning JJ, Sutton R. Ultrasound of the common bile duct in patients undergoing cholecystectomy. J Clin Ultrasound 1991; 19: 73-76 [PMID: 1847951].
Hammarström LE, Holmin T, Stridbeck H, Ihse I. Routine preoperative infusion cholangiography versus intraoperative cholangiography at elective cholecystectomy: a prospective study in 995 patients. J Am Coll Surg 1996; 182: 408-416 [PMID: 8620276].
Nanashima A, Abo T, Sakamoto I, et al. Three-dimensional cholangiography applying C-arm computed tomography in bile duct carcinoma: a new radiological technique. Hepatogastroenterology. 2009 May-Jun. 56(91-92):615-8.
Verma D, Kapadia A, Eisen GM, Adler DG. EUS vs MRCP for detection of choledocholithiasis. Gastrointest Endosc 2006; 64: 248-254 [PMID: 16860077 DOI: 10.1016/j.gie.2005.12.038]
Ainsworth AP, Rafaelsen SR, Wamberg PA, Durup J, Pless TK, Mortensen MB. Is there a difference in diagnostic accuracy and clinical impact between endoscopic ultrasonography and magnetic resonance cholangiopancreatography? Endoscopy 2003; 35: 1029-1032 [PMID: 14648416 DOI: 10.1055/ s-2003-44603] 66
Romagnuolo J, Bardou M, Rahme E, Joseph L, Reinhold C, Barkun AN. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139: 547-557 [PMID: 14530225 DOI: 10.7326/0003-4819-139-7-200310070-00006].
Hanada K, Iiboshi T, Ishii Y. Endoscopic ultrasound-guided choledochoduodenostomy for palliative biliary drainage in cases with inoperable pancreas head carcinoma. Dig Endosc. 2009 Jul. 21 suppl 1:S75-8.
Maranki J, Hernandez AJ, Arslan B, et al. Interventional endoscopic ultrasound-guided cholangiography: long-term experience of an emerging alternative to percutaneous transhepatic cholangiography. Endoscopy. 2009 Jun. 41(6):532-8.
Dhir V, Itoi T, Khashab MA, et al. Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach. Gastrointest Endosc. 2015 Apr. 81(4):913-23.
Mutignani M, Iacopini F, Perri V, et al. Endoscopic gallbladder drainage for acute cholecystitis: technical and clinical results. Endoscopy. 2009 Jun. 41(6):539-46.
Manes G, Paspatis G, Aabakken L et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019; 51: 472–491
Halldestam I, Enell EL, Kullman E et al. Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004; 91: 734–738.
Shabanzadeh DM, Sorensen LT, Jorgensen T. A prediction rule for risk stratification of incidentally discovered gallstones: results from a large cohort study. Gastroenterology 2016; 150: 156–167.
Buxbaum JL, Abbas Fehmi SM. ASGE Standards of Practice Committee. et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc 2019; 89: 1075–1105 [5] Talukdar R. Complications of ERCP. Best Pract Res Clin Gastroenterol 2016; 30: 793–805.
Cohn EM, Freiman HD. The diagnosis of common duct Costi R et al. Diagnosis and management of choledocholithiasis WJG|www.wjgnet.com 13395 October 7, 2014|Volume 20|Issue 37| stones by intravenous cholangiography compared with common duct exploration. Am J Gastroenterol 1961; 35: 513-517 [PMID: 13694470]
Mather JH, Williams WR. Cholecystography: the results of 125 consecutive cases examined by the oral administration of the salt. Br Med J 1927; 1: 614-615 [PMID: 20773106].
Sarli L, Pietra N, Franzé A, Colla G, Costi R, Gobbi S, Trivelli M. Routine intravenous cholangiography, selective ERCP, and endoscopic treatment of bile duct stones before laparoscopic cholecystectomy. Gastrointest Endosc 1999; 50: 200-208 [PMID: 10425413].
Sonnenberg A, Enestvedt BK, Bakis G. Management of suspected choledocholithiasis: a decision analysis for choosing the optimal imaging modality. Dig Dis Sci 2016; 61: 603 – 609
Meeralam Y, Al-Shammari K, Yaghoobi M. Diagnostic accuracy of EUS compared with MRCP in detecting choledocholithiasis: a meta-analysis of diagnostic test accuracy in head-to-head studies. Gastrointest Endosc 2017; 86: 986 – 993.
Giljaca V, Gurusamy KS, Takwoingi Y et al. Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Database Syst Rev 2015: CD011549.
Tse F, Yuan Y. Early routine endoscopic retrograde cholangiopancreatography strategy versus early conservative management strategy in acute gallstone pancreatitis. Cochrane Database Syst Rev 2012: CD009779.
Aabakken L, Bretthauer M, Line PD. Double-balloon enteroscopy for endoscopic retrograde cholangiography in patients with a Roux-en-Y anastomosis. Endoscopy. 2007 Dec. 39(12):1068-71.
Kruis T, Güse-Jaschuck S, Siegmund B, Adam T, Epple HJ. Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis. BMC Gastroenterol. 2020 Mar 12;20(1):65.
Center SA. Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract. 2009 May. 39(3):543-98.
Zhu AX, Hong TS, Hezel AF, Kooby DA. Current management of gallbladder carcinoma. Oncologist. 2010. 15(2):168-81.
O'Connell W, Shah J, Mitchell J, et al. Obstruction of the biliary and urinary system. Tech Vasc Interv Radiol. 2017 Dec. 20(4):288-93.
Williams EJ, Green J, Beckingham I, Parks R, Martin D, Lombard M. Guidelines on the management of common bile duct stones (CBDS). Gut 2008; 57: 1004-1021 [PMID: 18321943 DOI: 10.1136/gut.2007.121657
Schwartz SI. Gallbladder and extrahepatic biliary system. In: Schwartz SI, Lillehei RC, Shires GT, Spencer FC, Storer EH, editors. Principles of Surgery. Second Edition. New York: McGraw-Hill, 1974: 1221-1254 46
Kondo S, Isayama H, Akahane M, Toda N, Sasahira N, Nakai Y, Yamamoto N, Hirano K, Komatsu Y, Tada M, Yoshida H, Kawabe T, Ohtomo K, Omata M. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol 2005; 54: 271-275 [PMID: 15837409 DOI: 10.1016/ j.ejrad.2004.07.007].
Mather JH, Williams WR. Cholecystography: the results of 125 consecutive cases examined by the oral administration of the salt. Br Med J 1927; 1: 614-615 [PMID: 20773106].
Stott MA, Farrands PA, Guyer PB, Dewbury KC, Browning JJ, Sutton R. Ultrasound of the common bile duct in patients undergoing cholecystectomy. J Clin Ultrasound 1991; 19: 73-76 [PMID: 1847951].
Hammarström LE, Holmin T, Stridbeck H, Ihse I. Routine preoperative infusion cholangiography versus intraoperative cholangiography at elective cholecystectomy: a prospective study in 995 patients. J Am Coll Surg 1996; 182: 408-416 [PMID: 8620276].
Nanashima A, Abo T, Sakamoto I, et al. Three-dimensional cholangiography applying C-arm computed tomography in bile duct carcinoma: a new radiological technique. Hepatogastroenterology. 2009 May-Jun. 56(91-92):615-8.
Verma D, Kapadia A, Eisen GM, Adler DG. EUS vs MRCP for detection of choledocholithiasis. Gastrointest Endosc 2006; 64: 248-254 [PMID: 16860077 DOI: 10.1016/j.gie.2005.12.038]
Ainsworth AP, Rafaelsen SR, Wamberg PA, Durup J, Pless TK, Mortensen MB. Is there a difference in diagnostic accuracy and clinical impact between endoscopic ultrasonography and magnetic resonance cholangiopancreatography? Endoscopy 2003; 35: 1029-1032 [PMID: 14648416 DOI: 10.1055/ s-2003-44603] 66
Romagnuolo J, Bardou M, Rahme E, Joseph L, Reinhold C, Barkun AN. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139: 547-557 [PMID: 14530225 DOI: 10.7326/0003-4819-139-7-200310070-00006].
Hanada K, Iiboshi T, Ishii Y. Endoscopic ultrasound-guided choledochoduodenostomy for palliative biliary drainage in cases with inoperable pancreas head carcinoma. Dig Endosc. 2009 Jul. 21 suppl 1:S75-8.
Maranki J, Hernandez AJ, Arslan B, et al. Interventional endoscopic ultrasound-guided cholangiography: long-term experience of an emerging alternative to percutaneous transhepatic cholangiography. Endoscopy. 2009 Jun. 41(6):532-8.
Dhir V, Itoi T, Khashab MA, et al. Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach. Gastrointest Endosc. 2015 Apr. 81(4):913-23.
Mutignani M, Iacopini F, Perri V, et al. Endoscopic gallbladder drainage for acute cholecystitis: technical and clinical results. Endoscopy. 2009 Jun. 41(6):539-46.
Manes G, Paspatis G, Aabakken L et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019; 51: 472–491
Halldestam I, Enell EL, Kullman E et al. Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004; 91: 734–738.
Shabanzadeh DM, Sorensen LT, Jorgensen T. A prediction rule for risk stratification of incidentally discovered gallstones: results from a large cohort study. Gastroenterology 2016; 150: 156–167.
Buxbaum JL, Abbas Fehmi SM. ASGE Standards of Practice Committee. et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc 2019; 89: 1075–1105 [5] Talukdar R. Complications of ERCP. Best Pract Res Clin Gastroenterol 2016; 30: 793–805.
Cohn EM, Freiman HD. The diagnosis of common duct Costi R et al. Diagnosis and management of choledocholithiasis WJG|www.wjgnet.com 13395 October 7, 2014|Volume 20|Issue 37| stones by intravenous cholangiography compared with common duct exploration. Am J Gastroenterol 1961; 35: 513-517 [PMID: 13694470]
Mather JH, Williams WR. Cholecystography: the results of 125 consecutive cases examined by the oral administration of the salt. Br Med J 1927; 1: 614-615 [PMID: 20773106].
Sarli L, Pietra N, Franzé A, Colla G, Costi R, Gobbi S, Trivelli M. Routine intravenous cholangiography, selective ERCP, and endoscopic treatment of bile duct stones before laparoscopic cholecystectomy. Gastrointest Endosc 1999; 50: 200-208 [PMID: 10425413].
Sonnenberg A, Enestvedt BK, Bakis G. Management of suspected choledocholithiasis: a decision analysis for choosing the optimal imaging modality. Dig Dis Sci 2016; 61: 603 – 609
Meeralam Y, Al-Shammari K, Yaghoobi M. Diagnostic accuracy of EUS compared with MRCP in detecting choledocholithiasis: a meta-analysis of diagnostic test accuracy in head-to-head studies. Gastrointest Endosc 2017; 86: 986 – 993.
Giljaca V, Gurusamy KS, Takwoingi Y et al. Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Database Syst Rev 2015: CD011549.
Tse F, Yuan Y. Early routine endoscopic retrograde cholangiopancreatography strategy versus early conservative management strategy in acute gallstone pancreatitis. Cochrane Database Syst Rev 2012: CD009779.
Aabakken L, Bretthauer M, Line PD. Double-balloon enteroscopy for endoscopic retrograde cholangiography in patients with a Roux-en-Y anastomosis. Endoscopy. 2007 Dec. 39(12):1068-71.
Publicado
2021-11-13
Cómo citar
Nava-Pérez, C. (2021). Manejo y conducta actualizada de ictericia obstructiva: Management and updated behavior of obstructive jaundice. Revista Profesional HígadoSano, (22), 28-38. https://doi.org/10.5281/zenodo.5680205
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