Browsing by Author "Guzmán Bondiek, Sergio"

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    Enfermedad vesicular inaparente o microlitiasis en pacientes con pancreatitis aguda: Una situación clínica frecuente
    (1997) Miquel Poblete, Juan Francisco; Prado Sanhueza, María Alejandra; Asahi Kodama, Harumi Paz; Ibáñez Anrique, Luis Alberto; Guzmán Bondiek, Sergio; Cruz Olivos, Francisco; Rollan Rodríguez, Antonio Rafael; Nervi Oddone, Flavio
    Background: Patients with acute pancreatitis (AP) and a normal gallbladder by standard echographic evaluation may have "occult" gallbladder disease or microlithiasis with recurrent episodes of AP. Aim: To conduct a prospective evaluation of patients with the diagnosis of non-biliary AP in order to detect "occult" gallbladder disease and to compare its clinical presentation with that of biliary AP. Patients and methods: Patients admitted with the diagnosis of AP to a clinical hospital were included in the study. According to an abdominal ultrasound study, patients were classified as having or not cholelithiasis. A duodenal biliary drainage was performed in 15 patients with AP and without gallbladder stones. Results: Patients without cholelithiasis had recurrent AP more often than patients with biliary AP (53 and 33% respectively). Excessive alcohol ingestion did not rule out the possibility of biliary etiology. In 6 patients, the analysis of duodenal bile showed cholesterol crystals, and cholecystectomy confirmed the existence of gallbladder disease in 5. All of them remained asymptomatic during a follow-up period of four years. One patient refused surgery, with subsequent development of gallstones and recurrent episodes of AP. In other 4 patients, gallbladder disease was confirmed by percutaneous gallbladder puncture or during cholecystectomy. No recurrence of AP were observed during the follow-up. Conclusions: Microlithiasis or "occult" gallbladder disease accounts for at least 67% of the original "non-biliary" AP. Duodenal bile analysis is a useful and necessary technique for the evaluation of patients with "non-biliary" acute pancreatitis'. Careful clinical and echographic follow-up of this subgroup of patients with AP is mandatory.
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    Metástasis hepática de origen no colorrectal ni neuroendocrino. Tratamiento quirúrgico
    (2010) Yáñez M, R.; Gamboa C, C.; Crovari Eulufi, Fernando; Guzmán Bondiek, Sergio; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Curi Tuma, Maximiliano; Weisse Ayach, Osvaldo; Guerra Castro, Juan Francisco
    Introducción: Existe un claro beneficio en el tratamiento quirúrgico de las metástasis hepáticas de origen colorrectal y neuroendocrinas; sin embargo, todavía no está bien definida la efectividad de la resección quirúrgica en tumores de origen diferente a los anteriores. El objetivo del presente estudio es dar a conocer los resultados del tratamiento quirúrgico en este grupo de pacientes. Pacientes y Método: Análisis de la base de datos electrónica de los pacientes con metástasis hepáticas de origen no colorrectal ni neuroendocrina que fueron sometidos a resección hepática en nuestro centro entre los años 2000-2009. Resultados: La serie estuvo constituida por 17 pacientes, nueve mujeres, mediana de edad de 51 años (rango, 22-78). Los principales sitios de origen del tumor primario fueron estómago, hígado, glándulas suprarrenales y útero. En dos casos se realizó cirugía sincrónica del primario y las metástasis; la técnica utilizada fue segmentectomía anatómica en 10 pacientes (58,8%) y resección anatómica mayor los siete restantes (41,2%). En 15 pacientes (88,2%) se logró borde quirúrgico libre de tumor, tres pacientes presentaron complicaciones postoperatorias y en tres hubo recidiva de la lesión hepática. No hubo mortalidad operatoria. Tras un seguimiento de 21 meses (rango, 9-56) la supervivencia al año, a los dos y a los tres años fue de 85%, 51% y 51% respectivamente. Discusión: El tratamiento quirúrgico de los pacientes con metástasis hepáticas de origen no colorrectal ni neuroendocrino es seguro y parece beneficioso en pacientes seleccionados, con baja tasa de complicaciones y con supervivencia favorable.
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    Microlithiasis and cholesterolosis in idiopathic acute pancreatitis
    (W. B. Saunders Co., 1992) Miquel Poblete, Juan Francisco; Rollan Rodríguez, Antonio Rafael; Guzmán Bondiek, Sergio; Nervi Oddone, Flavio
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    Tratamiento de la hemorragia digestiva alta no variceal con termocoagulación endoscópica
    (1992) Ibáñez Anrique, Luis; Chianale Bertolini, José Luis; Siegel, F.; Miquel Poblete, Juan Francisco; Guzmán Bondiek, Sergio; Llanos Valdés, Osvaldo Pablo
    Over a year period, 60 of 172 patients presenting with upper gastrointestinal bleeding were treated by endoscopic thermocoagulation. Entry criteria included active bleeding (pulsatile or oozing), a visible vessel, sentinel clot or the presence of a pigmented protuberance at the ulcer crater. Hemostatic therapy was performed using the heat probe. The physical status and risk of the patients was estimated according to the ASA classification. Hemostasis was obtained in 17 of 21 patients with pulsatile bleeding (81%), 30 of 30 patients with oozing (100%) and 18 of 18 patients with a visible vessel or a pigmented protuberance in the lesion (100%). Three patients, older than 70 years of age, died. All had pulsatile bleeding from a deep ulcer located at the posterior-inferior wall of the duodenal bulb. They were classified as ASA III (n = 1) or IV (n = 2) with significant concomitant illness. These results suggest that endoscopic thermocoagulation is an effective treatment of active upper gastrointestinal bleeding, especially useful in a group of high risk patients.