<?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>2444-6483</journal-id>
<journal-title><![CDATA[Endoscopia]]></journal-title>
<abbrev-journal-title><![CDATA[Endoscopia]]></abbrev-journal-title>
<issn>2444-6483</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Endoscopia Gastrointestinal A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-64832019000600280</article-id>
<article-id pub-id-type="doi">10.24875/end.m19000109</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Experiencia en el manejo endoscópico de la coledocolitiasis de la Unidad Médico-Quirúrgica Juárez Centro]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tepepa-López]]></surname>
<given-names><![CDATA[Francisco Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Marín]]></surname>
<given-names><![CDATA[Alan Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amador-Miranda]]></surname>
<given-names><![CDATA[Bernardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Becerra-Blancas]]></surname>
<given-names><![CDATA[Francisco Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lagunas-Quiroz]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas-de León]]></surname>
<given-names><![CDATA[Cruz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Secretaría de Salud Unidad Médico-Quirúrgica Juárez Centro Servicio de Endoscopia Gastrointestinal]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<volume>31</volume>
<fpage>280</fpage>
<lpage>285</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-64832019000600280&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-64832019000600280&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-64832019000600280&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: La coledocolitiasis se define como la presencia de litos en el conducto colédoco. La mayoría de los litos en el colédoco se originan en la vesícula biliar. Diferentes estudios han informado que la coledocolitiasis se presenta en el 16% de los pacientes operados por litiasis vesicular. La mayoría de los cálculos de la vía biliar pueden extraerse con medidas convencionales (Instrumentación con canastilla o balón) en un 80-91%.  Objetivo: El objetivo principal de este estudio es describir el manejo endoscópioco de la coledocolitiasis en los pacientes que fueron sometidos a Colangiografía retrógrada endoscópica (CPRE) en la Unidad Médico-Quirúrgica Juárez Centro.  Material y métodos: Se presenta un estudio retrospectivo, transversal, observacional, descriptivo, y comparativo que se realizó en el Servicio de Endoscopia Gastrointestinal de la Unidad Médico Quirúrgica &#8220;Juárez Centro&#8221; en la Ciudad de México, en el periodo comprendido del 1º de Octubre de 2018 al 31 de Marzo de 2019.  Resultados: Se realizaron en el Servicio de Endoscopia Gastrointestinal de la Unidad Médico-Quirúrgica Juárez Centro un total de 122 estudios de CPRE de los cuales a 53 se integró el diagnóstico de coledocolitiasis, de ellos fueron 7 (13.2%) pacientes de sexo masculino y 46 (86.8%), edad promedio fue de 42.53 años. La presentación del lito la media del tamaño del lito fue de 10.25mm con una moda de 5mm, un tamaño mínimo de 5mm y un tamaño máximo de 30mm, siendo unicamente un 17% (9) mayores a 15mm, teniendo una frecuencia del 64.2% (34) presentacion de lito único y un 35.8% (19) con coledocolitiasis múltiple, la forma oviode tuvo mayor frecuencia de presentación en un 58.5% (31) y facetato (varios lados ya sea triangulares o hexagonales) en un 41.5% (22). Con respecto a la localización el 98.1% (52) fue en la vía biliar extrahepática y un 1.9% (1) con presentación intrahepática. La anatomía de la vía biliar se presentó en un 88.8% (47) sin alteraciones y en un 11.3% (6) con agulaciones mayores a 130º. Para el tratamiento de la coledocolitiasis se realizo esfinterotomía en un 98.1% de las CPREs y solo en un 1.9% (1) no se realizó esfinterotomía, se realizó barrido con cánula de balón en un 100% de los casos. Se relizó esfinteroplastía en un 47.2% (25) y litotripsia mecánica en un 7.5% (4). Logrando un aclaramiento de la vía biliar en un 75.5% (40) de los casos y necesidad de colocar una protésis plástica para drenaje temproral de la vía biliar en un 24.5% (13). Las complicaciones durante el procedimiento fueron del 3.8% (2) comprendidas en un caso de sangrado de la esfinterotomía (1.9%) y un caso de ruptura de la canastilla (1.9%). Se realizó regresión logística binaria para tamaño de lito mayor a 15mm encontrando coeficiente B de 3.099 y error estándar del modelo de 0.914 con un OR de 22.167 (IC del 95% 3.694-133.06) con un P=0.001. Para esfinteroplastía coeficiente B de 2.324 con un error estándar del modelo de 0.837, un OR de 10.214 (IC 95% 1.980-52.696) con un P=0.006.  Conclusiones: La CPRE en nuestra experiencia se ha mostrado como un procedimiento seguro, útil y eficaz para el diagnostico y tratamiento de la coledocolitiasis de los pacientes que llegan referidos a nuestro servicio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary  Introduction: Choledocholithiasis is defined as the presence of stones in the common bile duct. The majority of the stones in the common bile duct originate in the gallbladder. Different studies have reported that choledocholithiasis occurs in 16% of patients operated on for gallbladder lithiasis. Most of the bile duct stones can be extracted with conventional measures (Instrumentation with basket or balloon) in 80-91%.  Objective: The main objective of this study is to describe the endoscopic management of choledocholithiasis in patients who underwent endoscopic retrograde cholangiography (ERCP) at Juarez Centro Medical-Surgical Unit.  Material and methods: We present a retrospective, cross-sectional, observational, descriptive, and comparative study that was conducted in the Gastrointestinal Endoscopy Service of the Juárez Centro Surgical Medical Unit in Mexico City, during the period of the 1st October 2018 to March 31, 2019.  Results: A total of 122 studies of ERCP were performed in the Gastrointestinal Endoscopy Service of the Juárez Centro Medical-Surgical Unit, of which 53 were diagnosed with choledocholithiasis, of which 7 (13.2%) were male patients. 46 (86.8%), average age was 42.53 years. The presentation of the lithium the average size of the stone was 10.25mm with a fashion of 5mm, a minimum size of 5mm and a maximum size of 30mm, being only 17% (9) greater than 15mm, having a frequency of 64.2% (34) presentation of single stone and 35.8% (19) with multiple choledocholithiasis, the oviode shape had a higher frequency of presentation in 58.5% (31) and facetato (several sides, triangular or hexagonal) in one 41.5% (22). With regard to localization, 98.1% (52) was in the extrahepatic bile duct and 1.9% (1) with intrahepatic presentation. The anatomy of the bile duct was presented in 88.8% (47) without alterations and in 11.3% (6) with agulations greater than 130º. For the treatment of choledocholithiasis, sphincterotomy was performed in 98.1% of the ERCPs and in only 1.9% (1) no sphincterotomy was performed, a balloon cannula was performed in 100% of the cases. Sphincteroplasty was performed in 47.2% (25) and mechanical lithotripsy in 7.5% (4). Achieving a clearing of the bile duct in 75.5% (40) of cases and the need to place a plastic prosthesis for tempororal drainage of the bile duct in 24.5% (13). Complications during the procedure were 3.8% (2) included in one case of sphincterotomy bleeding (1.9%) and one case of rupture of the basket (1.9%). Binary logistic regression was performed for lithium size greater than 15mm, finding coefficient B of 3.099 and standard error of the model of 0.914 with an OR of 22.167 (95% CI 3.694-133.06) with a P = 0.001. For sphincteroplasty coefficient B of 2.324 with a standard error of the model of 0.837, an OR of 10.214 (95% CI 1.980-52.696) with a P = 0.006.  Conclusions: ERCP in our experience has been shown as a safe, useful and effective procedure for the diagnosis and treatment of choledocholithiasis of patients who come referred to our service.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Colangiografia retrograda endoscopica (CPRE)]]></kwd>
<kwd lng="es"><![CDATA[Coledocolitiasis]]></kwd>
<kwd lng="en"><![CDATA[Endoscopic retrograde cholangiography]]></kwd>
<kwd lng="en"><![CDATA[Common bile duct stones]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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