Estenosis vía biliar: generalidades sobre su etiología, diagnóstico y tratamiento
Resumen
Introducción: En medicina, estenosis o estegnosis (del griego "contraído") es un término utilizado para denotar constricción o estrechamiento de un orificio o conducto corporal, como es la vía biliar.
Cuerpo de la revisión: Las estenosis benignas del conducto biliar pueden producirse por múltiples causas, las más comunes son iatrogénicas. La colecistectomía, sobretodo la resuelta vía laparoscópica, es la cirugía que se practica con mayor frecuencia por el cirujano general, siendo esta la causa más frecuente de lesión de las vías biliares extra-hepáticas, con posterior estenosis de la vía biliar. El diagnóstico es en su mayoría tardío, debutando principalmente con un cuadro de colestasia, que a la colangioresonancia magnética demuestra la estenosis.
Discusión: Tanto el radiólogo, endoscopista y cirujano deben evaluar las condiciones generales del caso, la etiología y las posibilidades terapéuticas, tanto paliativas, temporales o definitivas. Las lesiones estenosantes que mantienen continuidad bilioenteral son susceptibles de manejo radiológico y/o endoscópico, particularmente las lesiones de etiología benigna, usualmente post-quirúrgica. Aquellas con pérdida de continuidad requieren tratamiento quirúrgico. Las lesiones benignas no iatrogénicas (colangitis esclerosante o colangiopatía autoinmune) en condiciones excepcionales requieren cirugía. Debido a esto y a la poca frecuencia de otras causas etiológicas de estenosis, es que el siguiente artículo se enfocara en las de origen quirúrgico.
Palabras clave:
estenosis, vía biliar, colecistectomía, iatrogeniaReferencias
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