{"id":203,"date":"2018-12-19T16:17:47","date_gmt":"2018-12-19T14:17:47","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/?p=203"},"modified":"2018-12-19T16:17:47","modified_gmt":"2018-12-19T14:17:47","slug":"complicacions-en-cirurgia-del-pancrees","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/complicacions-en-cirurgia-del-pancrees\/","title":{"rendered":"Complicacions en cirurgia del p\u00e0ncrees. Qu\u00e8 pot passar?"},"content":{"rendered":"

Sovint els pacients que se sotmeten a una\u00a0cirurgia del p\u00e0ncrees<\/b><\/a>\u00a0tenen una gran preocupaci\u00f3 pel seu resultat i possibles complicacions.<\/span><\/span>\u00a0Aix\u00f2 \u00e9s degut en gran part a la mala fama que t\u00e9 l’adenocarcinoma de p\u00e0ncrees<\/b><\/a>, que a dia d’avui segueix constituint la indicaci\u00f3 principal de la\u00a0cirurgia de resecci\u00f3 del p\u00e0ncrees<\/b><\/a>.<\/span><\/span>\u00a0Cal recordar que, globalment,\u00a0el<\/strong>s pacients\u00a0intervinguts de c\u00e0ncer de p\u00e0ncrees\u00a0presenten una\u00a0superviv\u00e8ncia de nom\u00e9s el 20%\u00a0als 5 anys de la intervenci\u00f3<\/a>,<\/b>\u00a0i aquest fet, ben conegut pels pacients, fa que encarin la intervenci\u00f3 amb cert pessimisme.<\/span><\/span><\/p>\n

<\/p>\n

CIRURGIA DEL P\u00c0NCREES, DELICADA S\u00cd, PER\u00d2 NO SEMPRE<\/span><\/span><\/h2>\n

Addicionalment, la\u00a0cirurgia del p\u00e0ncrees<\/b><\/a><\/span><\/span>\u00a0<\/b><\/span>sempre ha tingut la fama de ser\u00a0delicada,<\/i>\u00a0i que comporta en la majoria dels pacients la pres\u00e8ncia de\u00a0complicacions postoperat\u00f2ries que poden arribar a tenir una certa import\u00e0ncia.<\/b><\/span><\/span>\u00a0Si b\u00e9 la realitat no \u00e9s aix\u00ed de dr\u00e0stica, \u00e9s cert que la cirurgia de resecci\u00f3 pancre\u00e0tica<\/strong><\/a> associa, fins i tot en centres amb un alt volum de pacients i per tant amb una gran experi\u00e8ncia, una taxa de complicacions gens menyspreable.<\/span><\/span><\/p>\n

Globalment,\u00a0les complicacions en cirurgia del p\u00e0ncrees solen estar al voltant del 40-50%,<\/b>\u00a0i\u00a0la mortalitat despr\u00e9s d’aquests procediments oscil\u00b7la entre un 1% i un 5%\u00a0(per a la\u00a0pancreatectomia corporocaudal<\/a>\u00a0i la\u00a0duodenopancreatectomia cef\u00e0lica<\/a>, respectivament).<\/span><\/span>\u00a0No obstant aix\u00f2, la mortalitat despr\u00e9s altres tipus de\u00a0resecci\u00f3 pancreatic<\/b>a<\/strong>\u00a0no tan extensa (les anomenades reseccions estalviadores de par\u00e8nquima com la enucleaci\u00f3, la uncinectom\u00eda o la\u00a0pancreatectomia central\u00a0) \u00e9s pr\u00e0cticament nul\u00b7la.<\/span><\/span><\/p>\n

\n

\n

\"dr-santiago-sanchez-cabus\"<\/h4>\n

“La cirurgia de resecci\u00f3 pancre\u00e0tica associa, fins i tot en centres amb un alt volum de pacients i per tant amb una gran experi\u00e8ncia, una taxa de complicacions gens menyspreable”<\/span><\/span><\/h4>\n

Dr.\u00a0Santiago S\u00e1nchez Cab\u00fas<\/a><\/p><\/blockquote>\n

A QU\u00c8 ES DEU AQUESTA ALTA TAXA DE COMPLICACIONS I FINS I TOT MORTALITAT?<\/span><\/span><\/h2>\n

Normalment aix\u00f2 passa com a conseq\u00fc\u00e8ncia de les anomenades\u00a0complicacions espec\u00edfiques pancre\u00e0tiques:<\/b>\u00a0retard del buidament g\u00e0stric, hemorr\u00e0gia pospancreatectom\u00eda i, per sobre de tot, la\u00a0f\u00edstula pancre\u00e0tica postoperat\u00f2ria.<\/b><\/span><\/span>\u00a0De fet, aquesta \u00faltima, amb freq\u00fc\u00e8ncia est\u00e0 implicada en la g\u00e8nesi de les altres dues.<\/span><\/span>\u00a0La\u00a0f\u00edstula pancre\u00e0tica<\/b>\u00a0significa la fugida de l\u00edquid pancre\u00e0tic ric en enzims digestius en el punt de l’anastomosi (la uni\u00f3 que el cirurgi\u00e0 realitza entre el p\u00e0ncrees i l’intest\u00ed) o la zona de secci\u00f3 del p\u00e0ncrees en una\u00a0pancreatectomia distal.<\/span><\/span>\u00a0Aquest l\u00edquid t\u00e9 com a missi\u00f3 la digesti\u00f3 de les prote\u00efnes, greixos i sucres de la dieta en l’intest\u00ed perqu\u00e8 es puguin absorbir.<\/span><\/span>\u00a0Si s’acumula l\u00edquid pancre\u00e0tic dins de la cavitat abdominal com a conseq\u00fc\u00e8ncia d’una fuita, pot desencadenar una digesti\u00f3 parcial d’estructures com intest\u00ed o vasos sanguinis provocant o b\u00e9 un proc\u00e9s infecci\u00f3s, un proc\u00e9s inflamatori important que comporti una par\u00e0lisi de l’est\u00f3mac (retard del buidament) o b\u00e9 una hemorr\u00e0gia que pot ser d’un got important.<\/span><\/span><\/p>\n

\n

\"dr-santiago-sanchez-cabus\"<\/h4>\n

“Normalment, les complicacions en cirurgia del p\u00e0ncrees, es produeixen com a conseq\u00fc\u00e8ncia de les anomenades\u00a0complicacions espec\u00edfiques pancre\u00e0tiques:<\/b>\u00a0retard del buidament g\u00e0stric, hemorr\u00e0gia pospancreatectom\u00eda i, per sobre de tot, la\u00a0f\u00edstula pancre\u00e0tica postoperat\u00f2ria”<\/b><\/span><\/span><\/h4>\n

Dr.\u00a0Santiago S\u00e1nchez Cab\u00fas<\/a><\/p><\/blockquote>\n

COM EVITAR LES COMPLICACIONS EN CIRURGIA DEL P\u00c0NCREES?<\/span><\/span><\/h2>\n

Per tal d’evitar l’aparici\u00f3 de complicacions en\u00a0cirurgia del p\u00e0ncrees<\/b><\/a><\/strong>, \u00e9s fonamental\u00a0realitzar una t\u00e8cnica quir\u00fargica adequada<\/b>\u00a0per\u00f2 tamb\u00e9\u00a0disposar en el centre d’un equip d’UCI<\/b><\/a>\u00a0que pugui gestionar el pacient complicat i\u00a0un servei de radiologia intervencionista<\/b>\u00a0experimentat, que pugui drenar possibles col\u00b7leccions o embolitzar (taponar)\u00a0vasos que puguin sagnar en el per\u00edode postoperatori.<\/span><\/span>\u00a0A m\u00e9s, la informaci\u00f3 aportada al pacient i fam\u00edlia \u00e9s essencial per a la comprensi\u00f3 del curs cl\u00ednic postoperatori d’aquests pacients.<\/span><\/span><\/p>\n

\n

\"dr-santiago-sanchez-cabus\"<\/h4>\n

“Per evitar les complicacions en una cirurgia del p\u00e0ncrees, \u00e9s fonamental\u00a0realitzar una t\u00e8cnica quir\u00fargica adequada, disposar en el centre d’un equip d’UCI<\/b>\u00a0que pugui gestionar el pacient complicat\u00a0i un servei de radiologia intervencionista<\/b>\u00a0experimentat”<\/span><\/span><\/h4>\n

Dr.\u00a0Santiago S\u00e1nchez Cab\u00fas<\/a><\/p><\/blockquote>\n

\n

\"cita-sanchez-cabus-cirugia-del-pancreas\"<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Sovint els pacients que se sotmeten a una\u00a0cirurgia del p\u00e0ncrees\u00a0tenen una gran preocupaci\u00f3 pel seu resultat i possibles complicacions.\u00a0Aix\u00f2 \u00e9s degut en gran part a la mala fama que t\u00e9 l’adenocarcinoma de p\u00e0ncrees, que a dia d’avui segueix constituint la indicaci\u00f3 principal de la\u00a0cirurgia de resecci\u00f3 del p\u00e0ncrees.\u00a0Cal recordar que, globalment,\u00a0els pacients\u00a0intervinguts de c\u00e0ncer de […]<\/p>\n","protected":false},"author":2,"featured_media":201,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[63,44],"tags":[50,49,64,57],"yoast_head":"\nComplicacions en cirurgia del p\u00e0ncrees. Qu\u00e8 pot passar?<\/title>\n<meta name=\"description\" content=\"Els pacients que se sotmeten a aquesta intervenci\u00f3 tenen una gran preocupaci\u00f3 pel seu resultat. 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