Caracterización de pacientes con colangitis diagnosticada mediante colangiopancreatografía retrógrada endoscópica en el Hospital Universitario San Rafael de Tunja
Abstract
Introduction: Cholangitis is a clinical syndrome characterized by jaundice, fever, and abdominal pain whose main cause is bile duct obstruction due to the presence of gallstones, which promotes bacterial growth. The main diagnostic method is the clinical presentation of the disease, and if it is not treated quickly int the first 24 hours, the patient´s survival may be compromised.
Materials and Methods: A retrospective cross-sectional descriptive study was conducted, where the electronic medical records of patients undergoing ERCP at the San Rafael Hospital in Tunja during the period from 2020 to 2022 in whom the presence of cholangitis was endoscopically detected were analyzed.
Results: A total of 70 patients were analyzed, the sex distribution was equal. The most frequent cause of obstruction was choledocholithiasis in 68.57% of cases, the average time of evolution was 7 days, being higher in patients from rural areas with 9 days. The most common comorbidity was hypertension (42,6%). The average surgical time was 34 minutes. In addition, 96.7% of patients received antibiotic treatment. Complications were infrequent, occurring in only 13,1% of the studied population. Post-ERCP mortality rate was 8.2%, occurring more frequently in patients over 80 years old.
Conclusions: In our department the most frequent cause for the development of cholangitis is choledocholithiasis, with longer access time to ERCP to people coming from rural areas.
Keywords
Colangiopancreatografia retrograda endoscopica, colangitis, comorbilidades, complicaciones, coledocolitiasis
Supplementary File(s)
original (Español)References
- An, Z., Braseth, A. L., & Sahar, N. (2021). Acute Cholangitis. Gastroenterology Clinics of North America. doi:10.1016/j.gtc.2021.02.005
- Sokal, A., Sauvanet, A., Fantin, B., & de Lastours, V. (2019). Acute cholangitis: Diagnosis and management. Journal of Visceral Surgery. doi:10.1016/j.jviscsurg.2019.05.007
- AnestesiaR. Colangitis aguda [Internet]. 2015 [Citado el 26 de mayo de 2023]. Disponible en: https://anestesiar.org/2015/colangitis-aguda/#:~:text=Etiolog%C3%ADa%20y%20epidemiolog%C3%ADa,%2D15%25%20(2).
- Garrote NES [Internet]. [cited 2023 May 26]. Available from: https://sintesis.med.uchile.cl/index.php/profesionales/informacion-para-profesionales/medicina/condiciones-clinicas2/medicina-interna/gastroenterologia/259-1-06-2-003
- Virgile J, Marathi R. Cholangitis. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Barberán Astudillo, L. del P., Jara Lanchi, F. G., Romero Soto, M. A., & Cruz Peliza, R. J. (2021). Utilidad y complicaciones de colangiopancreatografía retrógrada endoscópica (CPRE) en enfermedades biliopancreáticas. Journal of American Health. https://doi.org/10.37958/jah.v0i0.92
- Mohammad Alizadeh AH. Cholangitis: Diagnosis, Treatment and Prognosis. J Clin Transl Hepatol. 2017 Dec 28;5(4):404-413. doi: 10.14218/JCTH.2017.00028. Epub 2017 Sep 7. PMID: 29226107; PMCID: PMC5719198.
- Ahmed M. Acute cholangitis - an update. World J Gastrointest Pathophysiol. 2018 Feb 15;9(1):1-7. doi: 10.4291/wjgp.v9.i1.1. PMID: 29487761; PMCID: PMC5823698.
- Llumitaxi CJL, Guamán GNM, Lema TJG, et al. Colangitis aguda secundaria a coledocolitiasis en una paciente con lupus eritematoso sistémico.. Rev Cub de Reu. 2021;23(3):.https://www.medigraphic.com/pdfs/revcubreu/cre-2021/cre213n.pdf
- GONZÁLEZ M, A., ROJAS, O.. Colangitis aguda: Diagnóstico, complicaciones y mortalidad en el Hospital Universitario del Valle. Colombia Médica, North America, 15, aug. 2016. Disponible en: http://uvsalud.univalle.edu.co/colombiamedica/index.php/comedica/article/view/2493
- Soto Lecca VM. Hipertensión arterial como factor de riesgo para litiasis vesicular en pacientes adultos [Internet] [Tesis]. Hipertensión arterial como factor de riesgo para litiasis vesicular en pacientes adultos. 2019 [citado 30 May 2023]. Disp0onible en: https://hdl.handle.net/20.500.12759/5257
- Espinel J., Pinedo E.. Coledocolitiasis. Rev. esp. enferm. dig. [Internet]. 2011 Jul [citado 2023 Mayo 26] ; 103( 7 ): 383-383. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082011000700011&lng=es. https://dx.doi.org/10.4321/S1130-01082011000700011
- Antoniello L, García Calabria G, De Soto M. Prevalencia de la litiasis biliar en la diabetes mellitus. Revista médica de Uruguay. 1999 Apr;15(1):49–56.
- García-Cano Lizcano J, González Martín J. A, Morillas Ariño J, Pérez Sola A. Complicaciones de la colangiopancreatografía retrógrada endoscópica: Estudio en una unidad pequeña de CPRE. Rev. esp. enferm. dig. [Internet]. 2004 Mar [citado 2023 Mayo 26]; 96(3): 163-173. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082004000300002&lng=es.
- Langarica Zárate AM, Hernández Reyes RD, Hernández Mariscal C. Factores de riesgo predictores para complicaciones post-colangiopancreatografía retrógrada endoscópica. CIRUGÍA ENDOSCÓPICA. 2016;17(1):21–8.
- Osuna Ramírez I, Reyes Bastidas M del R, Suárez-Peredo LS, Ríos Ayala MA, Reyes Bastidas M, Reyes Moctezuma GA. Colangiopancreatografía retrógrada endoscópica en la tercera edad: factores de riesgo y complicaciones. ENDOSCOPIA. 2013;25(1):10–5.
- Barberán Astudillo L del P, Jara Lanchi FG, Romero Soto MA, Cruz Peliza RJ. Utilidad y complicaciones de colangiopancreatografía retrógrada endoscópica (CPRE) en enfermedades biliopancreáticas. Journal of American Health.2022;
- Kiriyama, S., Kozaka, K., Takada, T, et al. (2018), Directrices de Tokio 2018: criterios de diagnóstico y clasificación de la gravedad de la colangitis aguda (con videos). J Hepatobiliary Pancreat Sci, 25: 17-30. https://doi.org/10.1002/jhbp.512