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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991

Rev. Col. Bras. Cir. vol.25 no.2 Rio de Janeiro Mar./Apr. 1998

http://dx.doi.org/10.1590/S0100-69911998000200011 

ARTIGO DE ATUALIZAÇÃO

 

Colelitíase e cirrose hepática

 

Cholelithiasis and hepatic cirrhosis

 

 

Paulo Roberto Ott Fontes, TCBC-RSI; Mauro NectouxII; Rene Jacobsen EilersIII

IProfessor Livre-Docente em Cirurgia, Coordenador do Curso de Pós-Graduação em Clínica Cirúrgica da FFFCMPA/ISCMPA
IICirurgião Geral da ISCMPA, Mestre em Cirurgia
IIICirurgião Geral, Membro do SGCC

Endereço para correspondência

 

 


RESUMO

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.

Unitermos: Colelitíase; Cirrose hepática.


ABSTRACT

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.

Key words: Cholelithiasis; Hepatic cirrhosis.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

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Endereço para correspondência:
Dr. Paulo Roberto Ott Fontes
Rua General Vitorino, 330/802
90020-170 - Porto Alegre - RS
E-mail: prfontes@santacasa.tche.br

Recebido em 2/7/97
Aceito para publicação em 4/12/97

 

 

Trabalho do Serviço de Gastroenterologia Clínica e Cirúrgica (SGCC) do Complexo Hospitalar da Santa Casa de Porto Alegre e do Departamento de Cirurgia da Fundação Faculdade Federal de Ciências Médicas de Porto Alegre.

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