Tratamento cirúrgico da icterícia obstrutiva

Abstract

Os pacientes com icterícia obstrutiva devem ser avaliados e preparados adequadamente, antes da realização de procedimentos invasivos para reduzir as complicações, principalmente as infecciosas, distúrbios de coagulação sanguínea e insuficiência renal. As causas de icterícia obstrutiva são inúmeras, sendo a principal a litíase da via biliar principal. Cerca de 6-10% dos pacientes com litíase da vesícula biliar também apresentam cálculo na via biliar principal. Outras causas comuns de icterícia obstrutiva incluem obstrução maligna e estenoses benignas da via biliar principal. Hemobilia, doença de Caroli, cisto de cóledoco, divertículos duodenais e verminose das vias biliares são causas infreqüentes. O tratamento cirúrgico de todas estas condições é discutido.

Intrahepatic Ascariasis Leading to Liver Abscess

“…The treatment is generally carried out with anti-helmintic drugs and should not be managed in patients with parasites in the bile ducts, for the death of these ones leads to appearance of necrotic focus [8,9,12]. In such cases endoscopic removal may be performed as other surgical procedures, like choledochotomy or choledochoduodenostomy in case of failure [12,13]. When hepatic abscesses are already formed, the treatment of choice is the drainage and resection of affected liver segments.…”

“…When hepatic abscesses are already formed, the treatment of choice is the drainage and resection of affected liver segments. In such cases, patients can develop sepsis and even evolve to death (mortality can reach more than 10%) if it was not carried out properly during the early course of infestation [4,[12][13][14]. Despite of the slow recovery and prolonged hospitalization with intensive care in the PO, in this reported case, death had been avoided fortunately.…”