{"id":259,"date":"2019-03-29T12:07:53","date_gmt":"2019-03-29T10:07:53","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/?p=259"},"modified":"2019-03-29T12:07:53","modified_gmt":"2019-03-29T10:07:53","slug":"quin-paper-la-laparoscopia-la-cirurgia-del-pancrees","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/quin-paper-la-laparoscopia-la-cirurgia-del-pancrees\/","title":{"rendered":"Quin \u00e9s el paper de la laparosc\u00f2pia en la cirurgia del p\u00e0ncrees?"},"content":{"rendered":"

Dins de tot l’espectre de la\u00a0cirurgia abdominal<\/strong><\/a>, la\u00a0cirurgia pancre\u00e0tica<\/strong><\/a>\u00a0est\u00e0 considerada com una de les m\u00e9s exigents des del punt de vista t\u00e8cnic, aix\u00ed com pel que fa a la possible pres\u00e8ncia de complicacions postoperat\u00f2ries.<\/span>\u00a0Aix\u00f2 \u00e9s degut a les caracter\u00edstiques de\u00a0localitzaci\u00f3 anat\u00f2mica del p\u00e0ncrees<\/strong><\/a>, que es troba envoltat d’unes estructures vasculars summament importants i en una posici\u00f3 molt posterior a l’abdomen.\u00a0<\/span>Tamb\u00e9 influeixen les caracter\u00edstiques intr\u00ednseques de\u00a0la gl\u00e0ndula pancre\u00e0tica,<\/strong>\u00a0la consist\u00e8ncia, di\u00e0metre del conducte pancre\u00e0tic principal i la producci\u00f3 de l\u00edquid pancre\u00e0tic, poden jugar un paper determinant en l’aparici\u00f3 de complicacions.<\/span>\u00a0Per aquests motius, encara que la\u00a0laparosc\u00f2pia en la cirurgia del p\u00e0ncrees\u00a0<\/strong>sembla demostrar nombrosos avantatges, encara ha de consolidar-se.<\/span><\/p>\n

<\/p>\n

LA LAPAROSC\u00d2PIA EN LA CIRURGIA DEL P\u00c0NCREES, EN QUIN PUNT ESTEM?<\/span><\/h2>\n

Per les diferents complicacions i circumst\u00e0ncies abans esmentades, la introducci\u00f3 de\u00a0la laparosc\u00f2pia en la cirurgia del p\u00e0ncrees<\/strong>\u00a0ha estat significativament m\u00e9s tardana que en altres subespecialitats de\u00a0cirurgia abdominal,<\/strong>\u00a0com ara la\u00a0cirurgia del c\u00f2lon<\/strong><\/a>\u00a0o de\u00a0l’est\u00f3mac.<\/strong><\/span>\u00a0Despr\u00e9s de la primera intervenci\u00f3 practicada per laparosc\u00f2pia en l’any 1994, van passar molts anys fins que la\u00a0laparosc\u00f2pia<\/strong>\u00a0va esdevenir una eina habitual a la\u00a0cirurgia del p\u00e0ncrees<\/strong><\/a>.<\/span>\u00a0I dins d’aquesta, cal diferenciar la\u00a0cirurgia del cos-cua del p\u00e0ncrees<\/strong>\u00a0i la del\u00a0cap del p\u00e0ncrees,<\/strong>\u00a0sent aquesta \u00faltima d’una complexitat molt m\u00e9s gran.<\/span>\u00a0De fet, els registres recents nacionals d’implementaci\u00f3 de la\u00a0laparosc\u00f2pia en la cirurgia del p\u00e0ncrees<\/strong>\u00a0mostren una utilitzaci\u00f3 de la t\u00e8cnica que dista molt del 50% dels casos, sent molt minorit\u00e0ria en\u00a0cirurgia del cap pancre\u00e0tic.<\/strong><\/span><\/p>\n

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\"\"<\/strong><\/h4>\n

“La implementaci\u00f3 de la\u00a0laparosc\u00f2pia en la cirurgia del p\u00e0ncrees<\/strong>\u00a0dista molt del 50% dels casos, sent molt minorit\u00e0ria en cirurgia del cap pancre\u00e0tica”<\/span><\/h4>\n

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

QUINS AVANTATGES APORTA LA LAPAROSC\u00d2PIA EN LA CIRURGIA DEL P\u00c0NCREES?<\/span><\/h2>\n

El primer que conv\u00e9 assegurar \u00e9s que\u00a0la intervenci\u00f3 practicada ha de ser exactament igual a la realitzada per via cl\u00e0ssica oberta,<\/strong>\u00a0canviant \u00fanicament l’abordatge mitjan\u00e7ant la substituci\u00f3 d’una incisi\u00f3 generalment de grans dimensions, per 5-6 orificis, de fins a 15 mm a la\u00a0paret abdominal<\/strong><\/a>.<\/span>\u00a0Si b\u00e9 fins a la actualitat hi ha pocs estudis comparatius entre l’abordatge obert i el laparosc\u00f2pic, els resultats publicats mostren, de forma sistem\u00e0tica, una menor p\u00e8rdua sangu\u00ednia intraoperat\u00f2ria i una menor estada hospital\u00e0ria, aix\u00ed com un menor dolor postoperatori i uns millors resultats est\u00e8tics en els pacients intervinguts per laparosc\u00f2pia.<\/span>\u00a0A m\u00e9s, i a falta d’obtenir resultats d’estudis amb alt nivell d’evid\u00e8ncia cient\u00edfica, no sembla haver difer\u00e8ncies pel que fa als resultats a llarg termini en els pacients amb\u00a0c\u00e0ncer de p\u00e0ncrees<\/strong>\u00a0intervinguts mitjan\u00e7ant la laparosc\u00f2pia.<\/span><\/p>\n

\n

\"\"<\/strong><\/h4>\n

“Si b\u00e9 hi ha pocs estudis comparatius entre l’abordatge obert i la laparosc\u00f2pia en la cirurgia del p\u00e0ncrees, els resultats publicats mostren: menor p\u00e8rdua sangu\u00ednia intraoperat\u00f2ria, menor estada hospital\u00e0ria, menor dolor postoperatori i millors resultats est\u00e8tics.<\/span>\u00a0A m\u00e9s, no sembla haver difer\u00e8ncies quant a resultats a llarg termini en pacients amb c\u00e0ncer de p\u00e0ncrees”<\/span><\/h4>\n

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

No obstant aix\u00f2,\u00a0\u00e9s important individualitzar a cada pacient<\/strong>\u00a0i, en aquest sentit, hi ha intervencions que poden ser molt complexes per via laparosc\u00f2pica i que fins i tot poden significar un risc real per al pacient.<\/span>\u00a0Per aquest motiu,\u00a0\u00fanicament s’han de realitzar en el context d’un centre de refer\u00e8ncia, amb la tecnologia adequada i un equip amb gran experi\u00e8ncia en aquest camp.<\/strong><\/span><\/p>\n

\n
\n
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<\/p>\n

M\u00e9s informaci\u00f3 sobre la Cirurgia del P\u00e0ncrees a barnacl\u00ednic+<\/span><\/h2>\n

M\u00c9S INFORMACI\u00d3<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n

Sens dubte, amb l’objectiu de perseguir una millor atenci\u00f3 als pacients,\u00a0la laparosc\u00f2pia en la cirurgia del p\u00e0ncrees<\/strong>\u00a0s’ha d’implementar en el possible, at\u00e8s que sembla tenir avantatges en comparaci\u00f3 amb l’abordatge cl\u00e0ssic.<\/p>\n

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<\/p>\n

VOL CONTACTAR\u00a0AMB\u00a0EL DR. SANTIAGO S\u00c1NCHEZ CAB\u00daS?<\/span><\/h1>\n

DEMANAR CITA<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Dins de tot l’espectre de la\u00a0cirurgia abdominal, la\u00a0cirurgia pancre\u00e0tica\u00a0est\u00e0 considerada com una de les m\u00e9s exigents des del punt de vista t\u00e8cnic, aix\u00ed com pel que fa a la possible pres\u00e8ncia de complicacions postoperat\u00f2ries.\u00a0Aix\u00f2 \u00e9s degut a les caracter\u00edstiques de\u00a0localitzaci\u00f3 anat\u00f2mica del p\u00e0ncrees, que es troba envoltat d’unes estructures vasculars summament importants i en una […]<\/p>\n","protected":false},"author":2,"featured_media":254,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[63,44],"tags":[49,71,34],"yoast_head":"\nQuin \u00e9s el paper de la laparosc\u00f2pia en la cirurgia del p\u00e0ncrees?<\/title>\n<meta name=\"description\" content=\"La laparosc\u00f2pia en la cirurgia del p\u00e0ncrees s'ha d'implementar en el possible, at\u00e8s que sembla tenir avantatges en comparaci\u00f3 amb l'abordatge 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