<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2019000400423</article-id>
<article-id pub-id-type="doi">10.24875/ciru.19000683</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Impacto del protocolo propuesto por la American Society for Gastrointestinal Endoscopy en pacientes de alto riesgo de coledocolitiasis en el Hospital Regional ISSSTE Puebla en México]]></article-title>
<article-title xml:lang="en"><![CDATA[Impact of the protocol proposed by the American Society for Gastrointestinal Endoscopy in patients at high risk of choledocholithiasis, in Puebla Regional Hospital ISSSTE in Mexico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jesús-Flores]]></surname>
<given-names><![CDATA[Alberto De]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerrero-Martínez]]></surname>
<given-names><![CDATA[Gustavo A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional de Alta Especialidad Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>4</numero>
<fpage>423</fpage>
<lpage>427</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2019000400423&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2019000400423&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2019000400423&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La coledocolitiasis es una de las principales complicaciones de la colelitiasis, con una prevalencia en la población mexicana del 14%. El manejo a través de la guía propuesta por la American Society for Gastrointestinal Endoscopy (ASGE) en 2010 puede apoyar al cirujano para la resolución oportuna de la patología.  Objetivo: Determinar que el uso de la guía de la ASGE para el manejo de coledocolitiasis en pacientes con «alto riesgo» reduce las complicaciones de esta patología.  Método: Estudio comparativo, retrospectivo, de casos y controles, del 1 de enero de 2015 al 31 de diciembre de 2017. Se incluyeron pacientes que se estratificaron en alto riesgo de coledocolitiasis de acuerdo con la guía ASGE y se dividieron en dos grupos: el grupo de casos (diagnóstico por guía ASGE) fue sometido directamente a colangiopancreatografía retrógrada endoscópica (CPRE), y el otro grupo (no ASGE) siguió el protocolo de realizar tomografía computarizada, colangiorresonancia magnética y finalmente CPRE.  Resultados: De 61 pacientes con coledocolitiasis, se comparó entre los grupos la aparición de colangitis, las complicaciones posteriores a la CPRE, el tiempo de realización de la CPRE, los días de estancia hospitalaria y la mortalidad. Se obtuvo diferencia significativa en complicaciones tras la CPRE (grupo ASGE 3/35 [9%], grupo no ASGE 8/26 [30.7%]; odds ratio [OR]: 0.2; intervalo de confianza del 95% [IC 95%]: 0.05-0.9; p = 0.03) y en colangitis (grupo ASGE 2/35 [5.7%], grupo no ASGE 8/26 [30-7%]; OR: 0.13; IC 95%: 0.03-0.71; p = 0.009).  Conclusión: En nuestro medio, el empleo de la guía ASGE reduce la presencia de colangitis y las complicaciones tras la CPRE.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Choledocholithiasis is one of the main complications of cholelithiasis with a prevalence in the Mexican population of 14%. The management through the guide proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in 2010 can support the surgeon for the timely resolution of the pathology.  Objective: To determine that the guide proposed by ASGE for the management of choledocholithiasis in patients with "high risk" reduces the complications of this pathology.  Methods: A comparative, retrospective case-control study was conducted from January 1, 2015 to December 31, 2017. We included patients who were stratified at high risk of choledocholithiasis according to the ASGE guidelines. They were divided into 2 groups: the case group (diagnosis by ASGE guidelines) was submitted directly to endoscopic retrograde cholangiopancreatography (ERCP), the second group (no ASGE) followed the protocol of performing computed tomography, magnetic cholangioresonance, and finally ERCP.  Results: Of 61 patients with choledocholithiasis, the following groups were compared: the appearance of cholangitis, the complications after ERCP, time of ERCP, days of hospital stay and mortality. Obtaining significant difference in: "complications post ERCP" group ASGE 3/35 (9%), group no ASGE 8/26 (30.7%) with OR of 0.2 (0.05 - 0.9 IC 95%) and a p = 0.03; "Cholangitis" group ASGE 2/35 (5.7%), group no ASGE 8/26 (30-7%) with ORP 0.13 (0.03-0.71 IC 95%) and p = 0.009.  Conclusion: In our setting, the use of the ASGE guideline reduces the presence of cholangitis and post-ERCP complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[ASGE]]></kwd>
<kwd lng="es"><![CDATA[Coledocolitiasis]]></kwd>
<kwd lng="es"><![CDATA[CPRE]]></kwd>
<kwd lng="en"><![CDATA[ASGE]]></kwd>
<kwd lng="en"><![CDATA[Choledocholithiasis]]></kwd>
<kwd lng="en"><![CDATA[Endoscopic retrograde cholangiopancreatography]]></kwd>
</kwd-group>
</article-meta>
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