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Colelitíase e cirrose hepática Cholelithiasis and hepatic cirrhosis

By Paulo Roberto Ott Fontes, Mauro Nectoux and Rene Jacobsen Eilers

Abstract

Considerando que são duas doenças freqüentes na população, a associação entre cirrose hepática e colelitíase também é um achado comum. É importante o conhecimento desta situação porque a evolução clínica da cirrose pode ser complicada pela presença de colelitíase e, ao contrário, uma colelitíase sintomática pode ser de difícil tratamento nos pacientes cirróticos. Os autores fazem uma revisão da literatura enfocando os aspectos clínicos e terapêuticos desta associação.<br>The cholelithiasis and hepatic cirrhosis are frequent in the population. This association is often observed. It’s important to known this situation because the evolution of cirrhosis may be complicated by cholelithiasis and, on the other hand, the treatment of symptomatic cholelithiasis may be difficult in cirrhotic patients. In the compensated disease (Child A and B), cholecystectomy is the treatment of choice. In patients Child C, the biliary surgery has a high morbi-mortality rate and the initial management must be clinical observation. In these cases, the biliary symptoms must be relieved and the surgery delayed, if possible, until the improvement of hepatic function. Jaundiced patients must be carefully evaluated in the preoperative period, specially because choledocholithiasis is frequently absent and the jaundice is caused by hepatic failure. In Child C patients, if surgery is really necessary, cholecystostomy or partial cholecystectomy by Pribram technique can be considerated. The authors reviewed the clinical and therapeutic aspects of this association

Topics: Colelitíase, Cirrose hepática, Cholelithiasis, Hepatic cirrhosis, LCC:Surgery, LCC:RD1-811, LCC:Medicine, LCC:R, DOAJ:Surgery, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Colégio Brasileiro de Cirurgiões
Year: 1998
DOI identifier: 10.1590/S0100-69911998000200011
OAI identifier: oai:doaj.org/article:4e22673b20ab47d29c11751303941d08
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