Colecistitis aguda tg2013 tabata tinoco

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Tabata Ortiz

guías tokio 2013 colelitiasis

Health & Medicine

COLECISTITIS AGUDA TG2013
R1 TÁBATA LISSETTE TINOCO ORTIZ
PONTIFICIA UNIVERSIDAD CATÓLICA DEL ECUADOR
HOSPITAL METROPOLITANO
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

COLECISTITIS AGUDA
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

FISIOPATOLOGÍA
EVOLUCIÓN
DEPENDE DEL
GRADO DE
OBSTRUCCIÓN Y
DURACIÓN
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

CLASIFICACIÓN
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”
COLECISTITIS CRÓNICA: CUADROS REPETITIVOS, IRRITACIÓN
CRÓNICA CAMBIOS ATROFIA MUCOSA Y FIBROSIS DE LA PARED

ETIOLOGÍA
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”
Aumenta riesgo con
embarazos/terapia de
reemplazo hormonal
disminuye con lactancia.

“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”
COLECISTITIS XANTOGRANULOMATOSA

Formas especiales colecistitis
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

COMPLICACIONES DE COLECISTITIS
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

CRITERIOS DIAGNÓSTICOS Y DE SEVERIDAD
DE COLECISTITIS AGUDO
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

TRATAMIENTO QUIRÚRGICO DE
COLECISTITIS
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

PRONÓSTICO
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

MANEJO MEDICAMENTOSO
“TG13: Updated Tokyo guidelines for
Management of Acute Cholangitis and
Acute Cholecystitis”

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ACUTE CHOLECYSTITIS- RUQ ABDOMINAL PAIN #surgicaleducator #ruqabdominalpain #acutecholecystitis #usmle #babysurgeon #surgicaltutor • Dear Viewers, • Greetings from “Surgical Educator” • Today I have uploaded a video on Acute Cholecystitis • It is one of the common surgical problems you see in surgical wards. • I have discussed the various causes for RUQ pain, etiology, pathology, clinical features, investigations, complications and treatment of Acute Cholecystitis. • I have also included a mind map, a diagnostic and a treatment algorithm for Acute Appendicitis. • I hope the video will be very useful and you will enjoy it. • You can watch all my surgical teaching videos in the following links: • surgicaleducator.blogspot.com youtube.com/c/surgicaleducator • Thank you for watching the video.

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Gall stone ileus is complication of cholithiasis. It is rare and seen in aged patients diagnosed as cholelithiasis with co morbidities. High index of suspicion is necessary for arriving at a clinical diagnosis. Contrast enhanced computed tomography is diagnostic. Enterolithotomy followed by closure of the fistula with cholecystectomy as a two staged procedure is the safest approach for managing gall stone ileus.

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Compartimos con ustedes una actualización de la patología de la vesícula biliar y la revisión de las guías de Tokyo 2007 y 2013. Con esto se propone estandarizar las diferentes formas de tratamiento Quirúrgico (laparoscópico y abierto), endoscópico y percutáneo, a fin de ofrecer a nuestros pacientes lo mejor en cada caso y evitar al máximo una posible lesión quirúrgica de la vía biliar o complicaciones mayores..buen provecho. Dr. Sergio López Tórrez

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Acute cholecystitis is one of the commonest biliary tract emergency. Early diagnosis and prompt treatment is essential to reduce the morbidity and mortality associated with the disease. Assessment of the severity of the disease is essential to develop a safe therapeutic plan for the patient. The Tokyo guidelines (TG 18/TG 13) provides a lucid system for grading the severity of acute cholecystitis. Supportive care, antibiotic therapy followed by early laparoscopic cholecystectomy is the mainstay of treatment. Fitness to undergo surgery is determined by the Charlson Comorbidity Index and the American College of Anaesthesiologist’s physical status examination. Those unfit for surgery are best treated by early biliary drainage followed by delayed cholecystectomy. The incidence of iatrogenic bile duct injury is high in severe cases. A low threshold for conversion to open cholecystectomy is essential in such cases to prevent iatrogenic biliovascular injuries. A holistic clinical approach comprising of establishing the diagnosis, grading the severity of acute cholecystitis, assessment of fitness to undergo surgery, administration of supportive care and antibiotics followed by early cholecystectomy constitutes a safe surgical approach to acute cholecystitis.

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