Indications for papillotomy according to new pathophysiological acquisitions of the choledochopancreaticoduodenal confuent
Indicaciones de la papilotomía de acuerdo a las nuevas adquisiciones fisiopatológicas del confuente coledocopancreaticoduodenal
Resumen:
Comparing surgical experience with the data obtained from dne-radiography, seriography and electromanometric recordings, the location of the ampulla of Vater is set in the submucous segment of the oddian canal. Two types of calculus of the oddian canal are described: that of the ampulla and the mural calculus, with their clinical, diagnostic and surgical differences. The difficulties of biliary catheterism are studied, with a description of three types of angulation of the oddian canal, and recommendation for its straighteningby traction to ease the pasage of the catheter. For the extFaction of the calculus of the ampulla of Vater three maneuvres are recommended: retro duodeno pancreaticseparation, controlled catheterism and supported biliary dredging, which, properly carried out, make for greater success in the upper or choledocotomy route and more exceptional the need for duodenopapillotomy.
Confrontando la experiencia quirúrgica con los datos obtenidos con la cinerradiografía, la seriografía y los registros electromanométricos, se topografía la ampollade Vater en el segmento submucoso del canal oddiano. Se describen dos tipos de cálculos del canal oddiano: el de la ampolla y el mural, con sus diferencias clínicas, diagnósticas yquirúrgicas. Se estudian las dificultades del cateterismo, describiéndose tres tipos de angulaciones del canal oddiano, preconizándose su enderezamiento por tracción para facilitarel pasaje del catéter. Para la extracción del cálculo vateriano se aconsejan tres maniobras: el decolamiento retroduodenopancreático, el cateterismo fiscalizado y el dragado biliar apoyado que, realizadas correctamente, hacen más exitosa la vía alta de la coledocotomía y más excepcional la indicación de la duodenopapilotomía
2020 | |
cirugía esfínter de Oddi esfinterotomía surgery Oddi sphincter sphincterectomy |
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Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/2015 | |
Acceso abierto |
Sumario: | Comparing surgical experience with the data obtained from dne-radiography, seriography and electromanometric recordings, the location of the ampulla of Vater is set in the submucous segment of the oddian canal. Two types of calculus of the oddian canal are described: that of the ampulla and the mural calculus, with their clinical, diagnostic and surgical differences. The difficulties of biliary catheterism are studied, with a description of three types of angulation of the oddian canal, and recommendation for its straighteningby traction to ease the pasage of the catheter. For the extFaction of the calculus of the ampulla of Vater three maneuvres are recommended: retro duodeno pancreaticseparation, controlled catheterism and supported biliary dredging, which, properly carried out, make for greater success in the upper or choledocotomy route and more exceptional the need for duodenopapillotomy. |
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