Colecistostomía percutánea como tratamiento de colecistitis aguda: ¿qué ha pasado en los últimos 5 años? Revisión de la literatura

Acute cholecystitis is one of the most frequent diseases faced by the general surgeon. In recent decades, different prognostic factors have been observed, and effective treatments described, to improve the results in patients with said pathology (lower morbidity and mortality, shorter hospital stay, and minimum conversion of laparoscopic to open procedures). In general, laparoscopic cholecystectomy is the standard treatment for acute cholecystitis, but it is not exempt from complications, especially in patients with numerous comorbidities or those that are critically ill. Percutaneous cholecystostomy emerged as a less invasive alternative for the treatment of acute cholecystitis in patients with organ failure or a prohibitive surgical risk. Even though it is an effective procedure, its usefulness and precise indications are subjects of debate. In addition, there is little evidence on cholecystostomy catheter management. We carried out a review of the literature covering the main aspects physicians involved in the management of acute cholecystitis should be familiar with.     

Los artículos más citados en la Revista de Gastroenterología de México en un período de 22 años (1996-2018)

Introduction and aimThe Revista de Gastroenterología de México (RGM), founded in 1935, is one of the most influential journals of scientific dissemination in Mexico and Latin America. The aim of the present review was to characterize the RGM's most frequently cited original articles, review articles, and consensuses.MethodsThe most cited original articles, review articles, and consensuses of the RGM were identified using the Scopus, PubMed, and Google Scholar databases. Their designs and topics, as well as their authors and participating institutions, were analyzed.ResultsThe most highly cited articles of the RGM corresponded to the period from 1996 to 2018, with a mean of 16.5 citations per article. Fifty-eight percent (n = 29) of the articles belonged to the area of gastroenterology and 20% (n = 10) to surgery. The most frequent topics were functional gastrointestinal disorders, hepatitis virus, and gastric cancer. Thirty-six percent of the articles had a nonrandomized prospective design, followed by cross-sectional studies (26%) and randomized prospective studies (18%).ConclusionThe 50 most-cited articles included a total of 826 citations and the 10 most-cited consensuses and review articles had a total of 208 citations.Those studies encompass a diversity of disciplines related to gastroenterology that have impacted the scientific community and correspond to the work of different active research groups in Mexico and other countries.     

Utilidad de marcadores de inflamación para detectar fugas de anastomosis esofagoyeyunal

Introduction and aimTotal gastrectomy is utilized in different pathologies. Esophagojejunostomy leakage is a frequent complication. Our aim was to determine the association of the neutrophil-lymphocyte ratio (NLR) with esophagojejunostomy leakage that subsequently required invasive treatment.Materials and methodsA retrospective study included patients that underwent esophagojejunostomy within the time frame of 2002-2017. Patients were grouped into those with or without anastomotic leakage that had conservative treatment (Group A) and those with anastomotic leakage that had invasive treatment (Group B). ROC curves and the Youden index were used for the optimum cutoff values of the NLR.ResultsFifty-seven patients were included. Thirty-two (56.14%) were men, and mean patient age was 61.8 ± 13.4 years. Forty-five patients were assigned to Group A and 12 to Group B. Mean NLR was higher for group B on postoperative day 3 (Group A 9.5 ± 7.5 vs. Group B 13.9 ± 4.9) (P = .05). Mean total leukocytes was higher in Group B on postoperative day 5 (Group A 7.8 ± 3.4 × 10³/μl vs. Group B 10.3 ± 4.4 × 10³/μl) (P = .03). NLR and total leukocyte accuracy on postoperative day 3 was calculated with ROC curves, at 0.78 and 0.63, respectively. For the NLR and leukocyte count, sensitivity was 91.7 and 58%, specificity was 64.4 and 60%, positive predictive value was 40 and 28%, and negative predictive value was 96 and 84%, respectively.ConclusionsPostoperatively, the NLR identified the total gastrectomy with esophagojejunostomy patients that subsequently required an invasive procedure secondary to esophagojejunostomy leakage.