Coledocolitiasis: diagnóstico y manejo

Diagnosis and management of choledocholithiasis

La coledocolitiasis puede ocurrir hasta en el 15 % de los casos de colelitiasis. En la era moderna de la colecis­tectomía laparoscópica se ha planteado un debate sobre el manejo de la coledocolitiasis previo a la realiza­ ción del procedimiento quirúrgico. Varios estudios han investigado el uso de criterios preoperatorios, como las pruebas de función hepática, los hallazgos ecográficos y la clínica del paciente, para predecir el riesgo de cálculos en el colédoco. Los resultados varían un poco entre los estudios y de ellos se han desprendido diferentes esquemas y algoritmos para orientar el manejo, dentro del cual se incluyen técnicas tradicionales de cirugía abierta y las endoscópicas y laparoscópicas de más reciente aparición.

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