Colelitíase e cirrose hepática

Cholelithiasis and hepatic cirrhosis

ARTIGO DE ATUALIZAÇÃO

Colelitíase e cirrose hepática

Cholelithiasis and hepatic cirrhosis

Paulo Roberto Ott Fontes, TCBC-RS^I; Mauro Nectoux^II; Rene Jacobsen Eilers^III

^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.

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REFERÊNCIAS

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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.

Datas de Publicação

• Publicação nesta coleção
  05 Ago 2010
• Data do Fascículo
  Abr 1998

Histórico

• Aceito
  04 Dez 1997
• Recebido
  02 Jul 1997