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[Surgical treatment of gallstones].

Cholelithiasis is considered as a major health problem in Mexico do to its high prevalence. The spectrum of gallstones ranges from sympatomatic to asymptomatic gallbladder stones. The most frequent complications are acute cholecystitis, choledocholithiasis, cholangitis and pancreatitis. The standard method for diagnosis is ultrasonography but for a better evaluation and in order to cover the ultrasonographic faults, the oral cholecystogram is recovering value. Computarized axial tomography, technetium marked radionucleids and ERCP are valuable tools to avoid unnecessary surgical exploratory choledochotomies. The elective treatment for symptomatic cholelithiasis and asymptomatic cholelithiasis with risk factors in cholecystectomy with cholangiography at operating room. In choledocholitiasis the choice is choledochotomy with "T" tube drainage and sphincteroplasty and choledochoduodenal anastomosis evaluated at operating room. Acute cholecystitis is treated with early or emergency cholecystectomy. With the help of litotripsy, interventional radiology and endoscopy extraction, the procedures for treatment of biliary pathology the changing, both surgical and non surgical procedures are complementary.

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