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Id: lil-787886
Autor: Giménez, Mariano E; Palermo, Mariano; Houghton, Eduardo; Acquafresca, Pablo; Finger, Caetano; Verde, Juan M; Cúneo, Jorge Cardoso.
Título: Biodegradable biliary stents: a new approach for the management of hepaticojejunostomy strictures following bile duct injury. prospective study / Stent biliar biodegradável: uma nova abordagem para as estenoses hepaticojejunais após lesão do ducto biliar. estudo prospectivo
Fonte: ABCD arq. bras. cir. dig;29(2):112-116tab, graf.
Idioma: en.
Resumo: ABSTRACT Background: Once a biliary injury has occurred, repair is done by a hepaticojejunostomy. The most common procedure is to perform a dilatation with balloon with a success of 70 %. Success rates range using biodegradable stents is from 85% to 95%. Biodegradable biliary stents should change the treatment of this complication. Aim: To investigate the use of biodegradable stents in a group of patients with hepaticojejunonostomy strictures. Methods: In a prospective study 16 biodegradable stents were placed in 13 patients with hepaticojejunostomy strictures secondary to bile duct repair of a biliary surgical injury. Average age was 38.7 years (23-67), nine were female and four male. All cases had a percutaneous drainage before at the time of biodegradable stent placement. Results: In one case, temporary haemobilia was present requiring blood transfusion. In another, pain after stent placement required intravenous medication. In the other 11 patients, hospital discharge was the next morning following stent placement. During the patient´s follow-up, none presented symptoms during the first nine months. One patient presented significant alkaline phosphatase elevation and stricture recurrence was confirmed. One case had recurrence of cholangitis 11 months after the stent placement. 84.6% continued asymptomatic with a mean follow-up of 20 months. Conclusion: The placement of biodegradable stents is a safe and feasible technique. Was not observed strictures caused by the stent or its degradation. It could substitute balloon dilation in strictures of hepaticojejunostomy.

RESUMO Racional: Uma vez que lesão biliar ocorreu, o reparo é feito por hepaticojejunostomia. O procedimento mais comum é efetuar dilatação com balão com sucesso de 70%. As taxas de sucesso utilizando stents biodegradáveis ​​é de 85% a 95%. Stents biliares biodegradáveis ​​devem mudar o tratamento desta complicação. Objetivo: Investigar o uso de stents biodegradáveis em um grupo de pacientes com estenose hepaticojejunal Métodos: Em estudo prospectivo 16 stents biodegradáveis ​​foram colocados em 13 pacientes com estenose de hepaticojejunostomia secundárias usados para reparação do ductos biliares de lesão cirúrgica. A média de idade foi de 38,7 anos (23-67), nove pacientes eram homens e quatro mulheres. Todos os casos tiveram drenagem percutânea antes do momento da colocação de stent biodegradável. Resultados: Em um caso, haemobilia temporária estava presente com necessidade de transfusão de sangue. Em outro, dor após a colocação do stent necessitou de medicação intravenosa. Nos outros 11 pacientes, alta hospitalar foi na manhã seguinte após o procedimento. Durante o seguimento, nenhum apresentou sintomas durante os primeiros nove meses. Um paciente apresentou significativa elevação da fosfatase alcalina por recidiva da estenose. Um caso teve recorrência de colangite 11 meses após a colocação do stent. Continuaram assintomáticos 84,6% com média de acompanhamento de 20 meses. Conclusão: A colocação de stents biodegradáveis ​​é técnica segura e viável. Não foram observadas restrições causadas pelo stent ou pela sua degradação. Stent pode substituir dilatação com balão na estenose de hepaticojejunostomia.
Descritores: Complicações Pós-Operatórias/cirurgia
Ductos Biliares/cirurgia
Ductos Biliares/lesões
Ductos Biliares Intra-Hepáticos/cirurgia
Implantes Absorvíveis
Jejuno/cirurgia
-Anastomose Cirúrgica
Procedimentos Cirúrgicos do Sistema Biliar
Stents
Estudos Prospectivos
Constrição Patológica
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1153174
Autor: Pickell, Zachary; Raghavendran, Krishnan; Westerhoff, Maria; Williams, Aaron M.
Título: Acute hemorrhagic cholecystitis with gallbladder rupture and massive intra-abdominal hemorrhage
Fonte: Autops. Case Rep;11:e2020232, 2021. graf.
Idioma: en.
Resumo: Acute hemorrhagic cholecystitis is a rare, life-threatening condition that can be further complicated by perforation of the gallbladder. We describe a patient with clinical and radiologic findings of acute cholecystitis with a gallbladder rupture and massive intra-abdominal bleeding. Our patient is a 67-year-old male who presented with an ischemic stroke and was treated with early tissue plasminogen activator. His hospital course was complicated by a fall requiring posterior spinal fusion surgery. He recovered well, but several days later developed subxiphoid and right upper quadrant pain and an episode of hemobilia and melena. A computed tomography scan revealed an inflamed, distended gallbladder with indistinct margins and a large hematoma in the gallbladder fossa extending to the right paracolic gutter. The patient also developed hemodynamic instability concerning for hemorrhagic shock. He underwent an emergent laparoscopic converted to open subtotal fenestrating cholecystectomy with abdominal washout for management of his acute hemorrhagic cholecystitis with massive intra-abdominal hemorrhage. Prompt recognition of this lethal condition in high-risk patients is crucial for optimizing patient care.
Descritores: Procedimentos Cirúrgicos do Sistema Biliar
Colecistite Aguda/complicações
Vesícula Biliar/lesões
-Complicações Pós-Operatórias
Acidente Vascular Cerebral/cirurgia
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: BR26.7 - Serviço de Biblioteca e Documentação Científica


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Id: biblio-1089591
Autor: Tannuri, Ana Cristina Aoun; Hara, Lucas Arjona de Andrade; Paganoti, Guilherme de Freitas; Andrade, Wagner de Castro; Tannuri, Uenis.
Título: Choledochal cysts in children: How to Diagnose and Operate on
Fonte: Clinics;75:e1539, 2020. tab, graf.
Idioma: en.
Resumo: OBJECTIVE: To identify the best mode for diagnosing and treating the patients with choledochal cysts. METHODS: A retrospective study was performed with medical records of patients diagnosed with choledochal cysts from January 1994 to December 2017. In all cases, the diagnosis was based on ultrasound examination. All the patients underwent cyst resection and were divided in two groups: bile enteric anastomosis in the high portion of the common hepatic duct or in the dilated lower portion. RESULTS: Eighty-one cases were studied. The age of presentation was 4 y 2 mo ± 4 y 1 mo, and the age for the surgical treatment was 5 y 5 mo ± 4 y 6 mo. In 61 cases, US was the only image examination performed. There were 67 cases of Todani type I (82.7%), 13 cases of type IV (16.0%) and one case of type III (1.2%). Nine patients (29.0%) in the first period and 2 patients (4.0%) in the second period presented with postoperative complications (p=0.016). CONCLUSION: In patients with choledochal cysts, US is the only necessary diagnostic imaging. Performing the bile enteric anastomosis in the lower portion of the common hepatic duct is safer and has a lower risk of complications.
Descritores: Ductos Biliares/diagnóstico por imagem
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Cisto do Colédoco/cirurgia
Cisto do Colédoco/diagnóstico
-Complicações Pós-Operatórias
Cisto do Colédoco/classificação
Estudos Retrospectivos
Ultrassonografia
Resultado do Tratamento
Limites: Humanos
Criança
Responsável: BR1.1 - BIREME


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Id: biblio-838095
Autor: Waseem, David; Tushar, Patel.
Título: Intrahepatic, Perihilar and Distal Cholangiocarcinoma: Management and Outcomes
Fonte: Ann. hepatol;16(1):133-139, Jan.-Feb. 2017. graf.
Idioma: en.
Resumo: Abstract: Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsistent use of nomenclature for these cancers has obscured a true knowledge of the epidemiology, natural history and response to therapy of these cancers. Our aims were to define demographic characteristics, management and outcomes of these three distinct cancer types. Materials and methods. A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis. Results. 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma. Conclusion. Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.
Descritores: Neoplasias dos Ductos Biliares/terapia
Procedimentos Cirúrgicos do Sistema Biliar
Colangiocarcinoma/terapia
Antineoplásicos/uso terapêutico
-Fatores de Tempo
Neoplasias dos Ductos Biliares/classificação
Neoplasias dos Ductos Biliares/mortalidade
Neoplasias dos Ductos Biliares/patologia
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/mortalidade
Sistema de Registros
Florida
Estudos Retrospectivos
Resultado do Tratamento
Quimioterapia Adjuvante
Tumor de Klatskin/classificação
Tumor de Klatskin/mortalidade
Tumor de Klatskin/patologia
Tumor de Klatskin/terapia
Colangiocarcinoma/classificação
Colangiocarcinoma/mortalidade
Colangiocarcinoma/patologia
Radioterapia Adjuvante
Estimativa de Kaplan-Meier
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: lil-747629
Autor: Millán, Claudia Ximena; Torres, Mónica Patricia.
Título: Vesícula biliar a la izquierda del ligamento falciforme en ausencia de situs inversus: 'sinistraposición' / Gall bladder located to the left of the falciform ligament without situs inversus: "sinistraposition"
Fonte: Rev. colomb. cir;30(1):74-77, ene.-mar. 2015. ilus.
Idioma: es.
Resumo: La vesícula biliar ubicada a la izquierda del ligamento falciforme, en ausencia de situs inversus, también denominada 'sinistraposición', es una rara anomalía anatómica. Aunque es poco frecuente, se considera importante que todo cirujano se familiarice con este hallazgo, ya que la cirugía puede convertirse en un verdadero desafío técnico. En varios informes de casos, se ha documentado el manejo seguro de la 'sinistraposición' cuando es hallada de forma incidental durante una colecistectomía laparoscópica convencional. Así pues, este procedimiento puede practicarse de forma segura, aunque la lesión de la vía biliar no es inusual, dado que la asociación de estos casos a anomalías del árbol biliar y de la vena porta intrahepática no es despreciable. En el presente artículo se presenta el caso de un paciente con colelitiasis sintomática y ecografías que no reportaron la posición anómala de la vesícula biliar. Fue sometido a colecistectomía laparoscópica programada, en la cual se encontró una vesícula biliar ubicada en el segmento III del hígado, aparentemente no asociada a otras alteraciones biliares extrahepáticas. El procedimiento se realizó por vía laparoscópica multipuerto, sin complicaciones para el paciente, quien hasta el momento se encuentra asintomático.

The gallbladder located to the left of the falciform ligament in absence of situs inversus, called sinistraposition, is a rare anatomic anomaly. Although infrequent, it is important that surgeons become familiar with this finding, for surgery can become a real technical challenge. Several case reports have documented the safe handling of sinistraposition when found incidentally during conventional laparoscopic cholecystectomy. We report the case of patient with asymptomatic cholecystectomy and ultrasound echography that did not report the anomalous location of the gallbladder. Elective laparoscopic cholecystectomy was performed, encountering a gallbladder located in the segment III of the liver, with no apparent associated extrahepatic biliary anomalies. The procedure was carried out by a multiport approach, without complications, and so far the patient is asymptomatic.
Descritores: Procedimentos Cirúrgicos do Sistema Biliar
-Anormalidades Congênitas
Ductos Biliares
Colecistectomia Laparoscópica
Responsável: CO113


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Id: biblio-1147981
Autor: Pereira Graterol, Freddy; Venales Barrios, Yajaira.
Título: Instrumentación de la vía biliar percutánea transhepática- laparoscópica: otra forma de "rendezvous" biliar / Laparoscopic-percutaneous transhepatic instrumentation: another form of biliary "rendezvous"
Fonte: Rev. colomb. cir;35(4):682-683, 2020. fig.
Idioma: es.
Descritores: Neoplasias dos Ductos Biliares
-Procedimentos Cirúrgicos do Sistema Biliar
Procedimentos Cirúrgicos Minimamente Invasivos
Cateteres
Limites: Humanos
Responsável: CO113


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Texto completo SciELO Chile
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Id: biblio-1058297
Autor: Muñoz C, César; Koch, Jaime Castillo.
Título: Resultados iniciales de un programa de cirugía hepato-bilio-pancreática laparoscópica en el Hospital Regional de Talca / Initial results of a laparoscopic hepato-biliary-pancreatic surgery program at the Regional Hospital of Talca
Fonte: Rev. cir. (Impr.);71(5):433-441, oct. 2019. tab, ilus.
Idioma: es.
Resumo: Resumen Introducción: La cirugía laparoscópica es la vía de abordaje de elección para el tratamiento de múltiples patologías abdominales, sin embargo, su desarrollo en la cirugía hepato-bilio-pancreática (HBP) ha sido más lento y heterogéneo. Objetivo: Presentar los resultados de la implementación y desarrollo de un programa de cirugía HBP laparoscópica en el Hospital de Regional de Talca. Materiales y Método: Estudio de serie de casos que incluye a todos los pacientes operados por una patología HBP por vía laparoscópica como acceso a la cavidad abdominal en el Hospital Regional de Talca entre el 1 de junio de 2014 y el 30 de junio de 2016. Resultados: Fueron 42 pacientes, 25 (59,5%) de sexo femenino. La mediana de edad fue 58 años (IQ25-75 38-64 años). 22 (52,4%) tuvo una cirugía abdominal previa en la mayoría de ellos por vía abierta. 22 (52,4%) pacientes fueron intervenidos por patología maligna. La indicación más frecuente fue la cirugía radical por cáncer de vesícula biliar en 10 (23,8%) casos y la hidatidosis hepática (HH) en 7 (16,7%). 1 (2,4%) paciente portador de una HH requirió de una conversión a laparotomía. 5 (11,9%) presentaron alguna morbilidad posoperatoria, 2 de ellos > III de Clavien. La mediana de recuperación funcional fue de 1 día (1-2) y la de estadía posoperatoria de 3 días (3-4). No hubo mortalidad a 90 días. Con una mediana de seguimiento de 26,5 (18-33) meses, 4 (19%) de los 21 pacientes oncológicos intervenidos con intención curativa presentaron recurrencia de la enfermedad, la mayoría de ellos sistémica y el 95% está libre de recurrencia a los 24 meses. Conclusiones: La implementación y el desarrollo de la cirugía hepato-bilio-pancreática (HBP) por vía laparoscópica puede efectuarse en hospitales de referencia regional con los mismos estándares y resultados internacionales.

Introduction: Laparoscopic surgery is the preference access for the treatment of various abdominal pathologies, however, its development in hepato-biliary-pancreatic (HBP) surgery has been slower and heterogeneous. Aim: Present the results of the implementation and development of a laparoscopic HBP surgery program at the Regional Hospital of Talca. Materials and Method: Case series study in which were included all patients submitted to laparoscopic surgery for treatment of HPB pathology as access to the abdominal cavity in the Regional Hospital of Talca between June 1, 2014 and June 30, 2016. Results: There were 42 patients, 25 (59.5%) female. The median age was 58 years (IQ25-75 38-64 years). 22 (52.4%) had previous abdominal surgery in most of them by open route. 22 (52.4%) patients were operated on for malignant pathology. The most frequent indication was radical surgery for gallbladder cancer in 10 (23.8%) cases and hepatic hydatidosis (HH) in 7 (16.7%). 1 (2.4%) patient carrying a HH required a conversion to laparotomy. 5 (11.9%) presented some postoperative morbidity, 2 of them > Clavien III. The median functional recovery was 1 day (1-2) and the postoperative stay was 3 days (3-4). There was no mortality at 90 days. With a median follow-up of 26.5 (18-33) months, 4 (19%) of the 21 oncological patients operated on with curative intent presented recurrence of the disease, most of them systemic and 95% free from recurrence at 24 months. Conclusions: Implementation and development of HBP surgery by laparoscopy is feasible and it can be performed in regional referral hospitals with the same international standards and results.
Descritores: Pancreatopatias/cirurgia
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Hepatopatias/cirurgia
-Pancreatectomia/mortalidade
Período Pós-Operatório
Procedimentos Cirúrgicos do Sistema Biliar/mortalidade
Chile
Resultado do Tratamento
Laparoscopia/métodos
Recuperação de Função Fisiológica
Hepatectomia/mortalidade
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Estudo Clínico
Responsável: CL61.1 - Biblioteca Central Campus Sur


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Id: biblio-1115553
Autor: Castillo H, Felipe; Aretxabala U, Xabier De; Rencoret P, Guillermo; Vivanco L, Marcelo; Solano V, Nicolás; Hepp K, Juan.
Título: Técnica de linfadenectomía y resección del lecho vesicular laparoscópica por cáncer vesícula biliar incidental / Lymphadenectomy technique and laparoscopic vesicular bed resection for incidental gallbladder cancer
Fonte: Rev. cir. (Impr.);72(3):262-266, jun. 2020. ilus.
Idioma: es.
Resumo: Resumen El cáncer de vesícula es infrecuente a nivel mundial, a diferencia de su alta incidencia en Chile. Su pronóstico es malo en general, y dependerá de su forma de presentación, siendo mejor en los casos diagnosticados después de una colecistectomía laparoscópica por patología benigna. La reintervención, que incluye la resección hepática y linfadenectomía, es el pilar de la terapia curativa en esta neoplasia. Presentamos la descripción de la técnica quirúrgica realizada en los pacientes con cáncer de vesícula de diagnóstico incidental, en el Servicio de Cirugía de Clínica Alemana de Santiago y en el Hospital de la Fuerza Aérea de Chile. El abordaje laparoscópico representa una alternativa quirúrgica válida en el tratamiento de pacientes con cáncer de vesícula biliar diagnosticados después de la colecistectomía. La estandarización de la técnica debiera contribuir a su mayor empleo y a la obtención de buenos resultados desde un punto de vista oncológico.

Gallbladder cancer is considered an infrequent disease but in Chile has a higher incidence. Prognostic is considered dismal except in those patients in whom the diagnosis is performed after the cholecystectomy specimen study. Reoperation with gallbladder bed resection and lymphadenectomy is considered the treatment in patients with incidental cases. We show the way this operation is performed in Clinica Alemana of Santiago and in the Air Force Hospital. The laparoscopic approach is an alternative to those patients in whom the diagnosis was done after the cholecystectomy. Laparoscopy allows to accomplish same objectives and to obtain identical results that the open approach. The technical standardization should contribute to spread its employment and to improve the results.
Descritores: Procedimentos Cirúrgicos do Sistema Biliar/métodos
Vesícula Biliar/cirurgia
Neoplasias da Vesícula Biliar/cirurgia
Excisão de Linfonodo/métodos
-Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Laparoscopia
Gerenciamento Clínico
Achados Incidentais
Excisão de Linfonodo/normas
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL61.1 - Biblioteca Central Campus Sur


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Id: lil-713898
Autor: Katekaru Tokeshi, Doris Audrey.
Título: Variantes anatómicas de la vía biliar por colangiorresonancia magnética 3T en pacientes del Hospital Nacional Dos de Mayo, Agosto 2011 a Agosto 2012. Lima, Perú / Anatomic variants of the biliary tract by magnetic resonance cholangiography 3T in patients attended at the National Hospital Dos de Mayo, August 2011 to August 2012. Lima, Peru.
Fonte: Lima; s.n; 2013. 46 p. ilus, tab, graf.
Idioma: es.
Tese: Apresentada a Universidad Nacional Mayor de San Marcos. Facultad de Medicina para obtenção do grau de Especialista.
Resumo: OBJETIVO: Determinar la prevalencia de variantes anatómicas de la vía biliar por colangiorresonancia magnética (Colangio RM) 3 Tesla (T) en pacientes del Hospital Nacional Dos de Mayo durante el periodo agosto 2011 a agosto 2012. MATERIAL Y METODOS: Se realizó un estudio descriptivo, transversal y retrospectivo revisándose las colangio RM de 156 pacientes entre agosto 2011 a agosto 2012. Se empleó un resonador magnético Philips Achieva 3T siguiendo el protocolo de la institución. RESULTADOS: Se evaluó 156 pacientes, el rango de edad fue de 1 a 89 años, predominaron los mayores de 50 años (67.3 por ciento) y los de sexo masculino (60.9 por ciento). Se encontró 26 pacientes (16.6 por ciento) con variantes anatómicas de la vía biliar, siendo la más frecuente la inserción baja del conducto cístico (CC) en 9 casos (34.6 por ciento), seguido por la trifurcación biliar en 6 casos (23 por ciento) e inserción medial del CC en 5 casos (19.2 por ciento). CONCLUSIONES: El 16.6 por ciento de pacientes presentó variantes anatómicas de la vía biliar. La variante más frecuente fue la inserción baja del CC. Conocer las variantes anatómicas de la vía biliar es importante como evaluación previa a los procedimientos biliares intervencionistas y segmentectomías hepáticas para realizar un mejor planeamiento quirúrgico y evitar posibles complicaciones.

OBJECTIVE: Determine the prevalence of anatomic variants of the biliary tract by magnetic resonance cholangiography (MR Cholangio) 3 Tesla (T) in patients of the Hospital Nacional Dos de Mayo during the period August 2011 to August 2012. MATERIAL AND METHODS: Descriptive, transversal and retrospective study reviewing MR Cholangio of 156 patients from August 2011 to August 2012. Using a Philips Achieva 3T magnetic resonator, we follow our institutional protocol. RESULTS: We evaluated 156 patients, the age range was 1-89 years, predominated over age 50 (67.3 per cent) and male (60.9 per cent). We found 26 patients (16.6 per cent) wit anatomic variants of the biliary tract, the most common was lower cystic duct (CD) insertion in 9 cases (34.6 per cent), followed by biliary trifurcation in 6 cases (23 per cent)and medial insertion of CD in 5 cases (19.2 per cent). CONCLUSIONS: 16.6 per cent of patients had anatomic variants of the biliary tract. Lower CD insertion was the most common variant. Knowing the anatomic variants of the biliary tract is important as pre-assessment procedures and interventional biliary hepatic segmentectomy for better surgical planning and avoid possible complications.
Descritores: Colangiografia
Imageamento por Ressonância Magnética
Procedimentos Cirúrgicos do Sistema Biliar
Sistema Biliar/anatomia & histologia
-Estudos Retrospectivos
Estudos Transversais
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Adulto Jovem
Pessoa de Meia-Idade
Idoso de 80 Anos ou mais
Responsável: PE13.1 - Oficina de Biblioteca, Hemeroteca y Centro de Documentación
PE13.1; ME, WN, 185, K25, ej.1. 010000094212; PE13.1; ME, WN, 185, K25, ej.2. 010000094213


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Id: lil-176251
Autor: Del Castillo Yrigoyen, Mario; Rodríguez Castro, Manuel.
Título: Colecistectomía laparascópica en el Perú. Reporte preliminar de los primeros casos / Laparoscopic cholecystectomy in Peru. Primary report
Fonte: Rev. méd. hered;2(1):44-5, mar. 1991.
Idioma: es.
Descritores: Colecistectomia Laparoscópica/instrumentação
Colecistectomia Laparoscópica/métodos
Colecistectomia Laparoscópica
-Procedimentos Cirúrgicos do Sistema Biliar
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca



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