<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-0420</journal-id>
<journal-title><![CDATA[Cirugía paraguaya]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cir. Parag.]]></abbrev-journal-title>
<issn>2307-0420</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-04202018000300018</article-id>
<article-id pub-id-type="doi">10.18004/sopaci.2018.diciembre.18-25</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[MANEJO PREOPERATORIO DE LA ICTERICIA OBSTRUCTIVA]]></article-title>
<article-title xml:lang="en"><![CDATA[PREOPERATIVE MANAGEMENT OF OBSTRUCTIVE JAUNDICE]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivas Villamayor]]></surname>
<given-names><![CDATA[Coral Alejandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira Gaona]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Porto Varela]]></surname>
<given-names><![CDATA[Mauro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montiel-Roa]]></surname>
<given-names><![CDATA[Arnaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Central - Instituto de Previsión Social  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>42</volume>
<numero>3</numero>
<fpage>18</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-04202018000300018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-04202018000300018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-04202018000300018&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La ictericia obstructiva biliar es un síntoma que resulta de la colestasis. Las causas son variadas, pero es comúnmente debida a coledocolitiasis, estenosis de la vía biliar, tumores malignos biliopancreáticos y enfermedades metastásicas.  Objetivo: Describir el manejo preoperatorio de la ictericia obstructiva.  Metodología:  Investigación observacional, con estudio retrospectivo, descriptivo de expedientes clínicos de pacientes con ictericia obstructiva, tratados en el Hospital Central &#8220;Dr. Emilio Cubas&#8221; de enero a diciembre de 2017.  Resultados: Se analizaron 81 expedientes clínicos, media de edad 60,22 ± 15,65 años (91-23), 60,49% mujeres. En promedio la bilirrubina total fue 8,40 ± 6,90 mg/dl y bilirrubina directa 5,13 ± 3,92 mg/dl, fosfatasa alcalina 955,65 ± 658,61 U/L y gamma GT 270,56 ± 207,35 U/L. El colédoco en promedio de 11,64 ± 5,76 mm por ecografía. Acompañado de dolor (97,53%), ictericia (93,83%), coluria (87,65%), acolia (53,09%) y prurito 4,94%. Se estudió con ecografía (100%), resonancia magnética (49,38%) y tomografía simple (41,98%), la colangioretrograda endoscópica como diagnóstica y terapéutica (83,95%), con una complicación del 4,94%. La coledocolitiasis fue la etiopatogenia más frecuente; 58 casos (71,60%), luego la coledocolitiasis asociada a otras patologías en 5 casos (5,65%). De las causas mas frecuentes de ictericia neoplasica fue el cáncer de páncreas, 7 casos (8,64%). En la coledocolitiasis se realizó colangioretrograda endoscópica en 49 casos (84,48%), luego se completó la colecistectomía en 32 (55,17%), la colecistectomía mascolangiointraoperatoria en 9 (15,52%) casos y 1 (1,72%) caso requirió derivación biliodigestiva. Las neoplasias malignas fueron de manejo paliativo, excepto 1 caso de ampuloma.  Conclusión: la causa más frecuente de la ictericia obstructiva litiasica según este estudio, es la coledocolitiasis, con afección principal en mujeres. Como tratamiento definitivo, la colangiografia y/o la colecistectomía (con colangiografiaintraoperatoria) fueron el manejo estándar.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY  Introduction: Biliary obstructive jaundice is a symptom that results from cholestasis. The causes are varied, but it is commonly due to choledocholithiasis, stenosis of the bile duct, malignant biliopancreatic tumors and metastatic diseases.  Objective: To describe the preoperative management of obstructive jaundice.  Methodology: Observational research, with a retrospective, descriptive study of clinical records of patients with obstructive jaundice, treated at the Central Hospital "Dr. Emilio Cubas "from January to December 2017.  Results: 81 clinical files were analyzed, mean age 60.22 ± 15.65 years (91-23), 60.49% women. On average, total bilirubin was 8.40 ± 6.90 mg / dl and direct bilirubin 5.13 ± 3.92 mg / dl, alkaline phosphatase 955.65 ± 658.61 U / L and gamma GT 270.56 ± 207 , 35 U / L. The common bile duct on average of 11.64 ± 5.76 mm by ultrasound. Accompanied by pain (97.53%), jaundice (93.83%), coluria (87.65%), acolia (53.09%) and pruritus 4.94%. Ultrasound (100%), magnetic resonance (49.38%) and simple tomography (41.98%), endoscopic cholangioretrography as diagnostic and therapeutic (83.95%), with a complication of 4.94%, were studied. Choledocholithiasis was the most frequent etiopathogenesis; 58 cases (71.60%), then the choledocholithiasis associated with other pathologies in 5 cases (5.65%). Of the most frequent causes of neoplasic jaundice was pancreatic cancer, 7 cases (8.64%). In choledocholithiasis, endoscopic cholangioretrography was performed in 49 cases (84.48%), then cholecystectomy was completed in 32 (55.17%), cholangio-surgical cholecystectomy in 9 (15.52%) cases and 1 (1.72). %) case required biliodigestive bypass. The malignant neoplasms were of palliative management, except 1 case of ampuloma.  Conclusion: the most frequent cause of obstructive lithiasic jaundice according to this study is choledocholithiasis, with the main condition in women. As a definitive treatment, cholangiography and / or cholecystectomy (with intraoperative cholangiography) were the standard management.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ictericia Obstructiva]]></kwd>
<kwd lng="es"><![CDATA[Coledocolitiasis]]></kwd>
<kwd lng="es"><![CDATA[Ultrasonografía]]></kwd>
<kwd lng="es"><![CDATA[Imagen por resonancia magnética]]></kwd>
<kwd lng="es"><![CDATA[Colangiografía]]></kwd>
<kwd lng="en"><![CDATA[Obstructive jaundice]]></kwd>
<kwd lng="en"><![CDATA[choledocholithiasis]]></kwd>
<kwd lng="en"><![CDATA[Ultrasonography]]></kwd>
<kwd lng="en"><![CDATA[Magnetic resonance imaging]]></kwd>
<kwd lng="en"><![CDATA[Cholangiography]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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