<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2011-7582</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[rev. colomb. cir.]]></abbrev-journal-title>
<issn>2011-7582</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2011-75822025000200320</article-id>
<article-id pub-id-type="doi">10.30944/20117582.2797</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Colangiopancreatografía retrógrada endoscópica, simplificación del protocolo para resolución de pacientes vulnerables en Venezuela]]></article-title>
<article-title xml:lang="en"><![CDATA[Endoscopic retrograde cholangiopancreatography, simplification of the protocol for resolution of vulnerable patients in Venezuela]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castillo-Arrieta]]></surname>
<given-names><![CDATA[Yhonny]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castillo-Ayala]]></surname>
<given-names><![CDATA[Diego]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueroa]]></surname>
<given-names><![CDATA[Frank]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Traviezo-Valles]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Policlínica Barquisimeto Departamento de Gastroenterología ]]></institution>
<addr-line><![CDATA[Barquisimeto ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Centroccidental &#8220;Lisandro Alvarado&#8221; Decanato de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Barquisimeto ]]></addr-line>
<country>Venezuela</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<volume>40</volume>
<numero>2</numero>
<fpage>320</fpage>
<lpage>330</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2011-75822025000200320&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2011-75822025000200320&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2011-75822025000200320&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  La colangiopancreatografía retrógrada endoscópica (CPRE) es una herramienta diagnóstica y terapéutica, usada en el tratamiento de patologías pancreatobiliares. Es un procedimiento con riesgos, que, en manos de endoscopistas especializados, se ejecuta con amplios márgenes de confianza. La adecuación de sus protocolos, manteniendo márgenes de seguridad, permite reducir costos, beneficiando a los pacientes de menos recursos que no pueden acceder a otros sistemas de salud. El objetivo de este estudio fue dar a conocer la experiencia de manejo ambulatorio y las estrategias para aminorar costos.  Métodos.  Estudio retrospectivo, transversal, basado en la simplificación de los protocolos, principalmente el traslado a hospitales cercanos para la observación posterior a la CPRE, el uso de sedación consciente para reducir los riesgos, la aplicación de medios de contraste diluidos, el uso de prótesis artesanales, no exigencia del informe cardiovascular ni otros estudios complejos de imágenes (sólo los necesarios) y la utilización de un área propia con todas las condiciones técnicas y asépticas necesarias.  Resultados.  En el período comprendido entre el 1° de julio de 2014 y el 30 de septiembre de 2024 se estudiaron 13.043 pacientes, 63,5 % de ellos mujeres. Las principales patologías tratadas fueron coledocolitiasis (19,6 %) y tumores de cabeza de páncreas (7,5 %). No hubo defunciones ni complicaciones atribuibles a la sedación. Se presentaron nueve fallecimientos posteriores al procedimiento lo cual corresponde al 0,069 % del total de pacientes analizados.  Conclusiones.  La simplificación de los protocolos para la CPRE, controlados por personal capacitado, logran un método seguro en procedimientos endoscópicos complejos, beneficiando a los más vulnerables carentes de alternativas terapéuticas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction.  Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic tool used in the treatment of pancreaticobiliary pathologies. It is a risky procedure, which in the hands of specialized endoscopists, is performed with wide margins of confidence. The adequacy of its protocols, while maintaining safety margins, allows for cost reduction, benefiting patients with fewer resources who cannot access other health systems. The objective of this study was to report the experience of ambulatory management and strategies to reduce costs.  Methods.  Retrospective, cross-sectional study, based on the simplification of protocols, mainly transfer to nearby hospitals for post-ERCP observation to hospitals, the use of conscious sedation to reduce risks, the application of diluted contrast media, the use of craft prostheses, no requirement for a cardiovascular report, or other complex imaging studies (only those necessary) and use of a dedicated area with all the necessary technical and aseptic conditions.  Results.  In the period from July 1, 2014 to September 30, 2024, 13,043 patients were studied, 63.5% of them women. The main pathology treated were choledocholithiasis (19.6%) and pancreatic head tumors (7.5%). There were no deaths or complications attributable to sedation. There were nine deaths after the procedure (0.06%), which corresponds to 0.069% of the total number of patients analyzed.  Conclusions.  The simplification of ERCP protocols, controlled by trained personnel, achieves a safe method in complex endoscopic procedures, benefiting the most vulnerable who lack therapeutic alternatives.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[conducto colédoco]]></kwd>
<kwd lng="es"><![CDATA[colangiopancreatografía retrógrada endoscópica]]></kwd>
<kwd lng="es"><![CDATA[sedación consciente]]></kwd>
<kwd lng="es"><![CDATA[complicaciones posoperatorias]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[Venezuela]]></kwd>
<kwd lng="en"><![CDATA[common bile duct]]></kwd>
<kwd lng="en"><![CDATA[endoscopic retrograde cholangiopancreatography]]></kwd>
<kwd lng="en"><![CDATA[conscious sedation]]></kwd>
<kwd lng="en"><![CDATA[postoperative complications]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[Venezuela]]></kwd>
</kwd-group>
</article-meta>
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