Complicações da cirurgia videolaparoscópica no tratamento de doenças da vesícula e vias biliares Videolaparoscopy complications in the management of biliary diseases

RACIONAL: O tratamento de escolha para as doenças da vesícula biliar é a colecistectomia, cujo objetivo é o alívio de sintomas e o tratamento e/ou prevenção das complicações. OBJETIVO: Identificar as principais complicações da cirurgia videolaparoscópica no tratamento das doenças da vesícula biliar e vias biliares. MÉTODO: Realizou-se busca eletrônica na base de dados LILACS e Medline desde o ano de 1981 a agosto de 2007; foram encontrados 57 artigos, sendo utilizados para o estudo 31 e três capítulos de livros. RESULTADOS: A produção científica submetida à análise de conteúdo evidenciou os seguintes núcleos temáticos: variações anatômicas (3 artigos), iatrogenias (5 artigos), síndrome pós-colecistectomia (1 artigo), complicações raras (3 artigos), síndrome de Mirizzi (1 artigo), complicações pulmonares (2 artigos) e tratamento (1 capítulo de livro e três artigos). CONCLUSÕES: As complicações que podem ocorrer na cirurgia videolaparoscópica da vesícula biliar e das vias biliares têm basicamente duas vertentes: uma é a inexperiência dos cirurgiões com o método laparoscópico (curva de aprendizado) e outra, as variações anatômicas com as quais os cirurgiões, mesmo os mais experientes, podem se deparar.<br>BACKGROUND: The treatment of choice for diseases affecting the gallbladder is the cholecystectomy, whose aim is improvement of symptoms, treatment and/or prevention of complications. AIM: Identify the main complications with laparoscopic surgery used to treat diseases affecting the gallbladder and the bile ducts. METHODS: An internet search in the LILACS and Medline database covering the period from 1981 up to August 2007 was carried out and 57 studies were found relevant. The present work draws on 31 of these studies and one textbook chapter. RESULTS: The analysis of the content of the studies selected yielded the following thematic issues: anatomic variations (3 studies), iatrogenies (5 studies), post-cholecystectomy syndrome (1 study), rare complications (3 studies), Mirizzi's syndrome (1 study), pulmonary complications (5 studies) and treatment (1 chapter of a medicine textbook and 3 studies). CONCLUSIONS: The complications arising from the videolaparoscopic surgery of the gallbladder and bile ducts are fundamentally due to two factors: the surgeon's lack of training in the laparoscopic technique (learning curve), and the unexpected anatomic variations, which even experienced surgeons may face

More than 10,000 pre-Columbian earthworks are still hidden throughout Amazonia.

This is the author accepted manuscript. The final version is available from the American Association for the Advancement of Science via the DOI in this recordData and materials availability: Data from publicly available sources are cited in the supplementary materials. Other data and computer codes used in the analysis are publicly available at Zenodo repositoryIndigenous societies are known to have occupied the Amazon basin for more than 12,000 years, but the scale of their influence on Amazonian forests remains uncertain. We report the discovery, using LIDAR (light detection and ranging) information from across the basin, of 24 previously undetected pre-Columbian earthworks beneath the forest canopy. Modeled distribution and abundance of large-scale archaeological sites across Amazonia suggest that between 10,272 and 23,648 sites remain to be discovered and that most will be found in the southwest. We also identified 53 domesticated tree species significantly associated with earthwork occurrence probability, likely suggesting past management practices. Closed-canopy forests across Amazonia are likely to contain thousands of undiscovered archaeological sites around which pre-Columbian societies actively modified forests, a discovery that opens opportunities for better understanding the magnitude of ancient human influence on Amazonia and its current state.Coordination of Superior Level Staff Improvement under the Academic Excellence Program (CAPES/PROEX)Coordination of Superior Level Staff Improvement under the Academic Excellence Program (CAPES/PROEX)Coordination of Superior Level Staff Improvement under the Academic Excellence Program (CAPES/PROEX)National Council for Scientific and Technological Development (CNPQ)National Council for Scientific and Technological Development (CNPQ)National Council for Scientific and Technological Development (CNPQ)European Research CouncilSão Paulo Research Foundation (FAPESP)Amazon FundSão Paulo Research Foundation (FAPESP)PVEMEC/MCTI/CAPES/CNPq/FAPEuropean Union’s Horizon 2020European Union’s Horizon 2020CAPESANRMCT/CNPq/CT-INFRA/GEOMAMCT/CNPq/CT-INFRA/GEOMACAPES/PDSECAPES/FapespaCNPqFAPESPCNPq/CAPES/FAPS/BC-NewtonFAPEMATRoyal Society GCRF International Collaboration AwardNSF/DEBCNPQ/PQNatural Environment Research Council (NERC)Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Gordon and Betty Moore Foundatio