Cambios fisiopatológicos y complicaciones de las resecciones hepáticas
Palabras clave:
cirugía hepática, morbilidad de la hepatectomía, post operatorio de las hepatectomías
Resumen
Las modernas técnicas quirúrgicas y anestésicas han permitido ampliar el número de intervenciones
quirúrgicas a nivel hepático por diversas patologías. Logrando disminuir su moralidad pero manteniendo al día de hoy elevados niveles de morbilidad. Durante la cirugía hepática se producen cambios hemodinámicos
vinculados a la movilización del hígado, a los clampeos y a las pérdidas sanguíneas independientemente de la vía de abordaje. En el postoperatorio las complicaciones o cambios fisiopatológicos derivan de las lesiones
producidas por los fenómenos de isquemia y reperfusión; y aquellas producidas por la regeneración hepática.
Dicha capacidad depende no solo de la cantidad de hígado remanente sino también de la posible hepatopatía preexistente. La insuficiencia hepática postoperatoria es la complicación más temida y se manifiesta con ictericia, ascitis, encefalopatía y alteraciones en la paraclínica como la hiperbilirrubinemia y descenso del tiempo de protrombina. Las complicaciones quirúrgicas dependen del procedimiento realizado y se dividen principalmente en biliares y vasculares. Las secuelas de las hepatectomías dependen de factores como el estado general del paciente, la presencia hepatopatía, el acto quirúrgico y la cantidad y calidad del hígado remanente.
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Publicado
2023-03-16
Cómo citar este artículo
Parada, U., Delgado, J., Pereyra, J., Andreoli, G., & Cazabán, L. (2023). Cambios fisiopatológicos y complicaciones de las resecciones hepáticas. Anales De La Facultad De Medicina, 10(1), e301. https://doi.org/10.25184/anfamed2023v10n1a6
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Derechos de autor 2023 Ulises Parada; Juan Delgado; Joaquín Pereyra; Gustavo Andreoli; Luis Cazabán
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