Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar

Estadísticamente la colecistectomia es el segundo procedimiento quirúrgico abdominal de urgencia mas realizado en todos los hospitales del mundo y el primero en el ambiente de la cirugía programada; conociendo estos datos, se diseño un protocolo Fast-Track Surgery con el fin de brindarle al paciente...

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Autores:
Calderon Pacheco, Luis Miguel
Saldarriaga Pedroza, Luis Guillermo
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2018
Institución:
Universidad Libre
Repositorio:
RIU - Repositorio Institucional UniLibre
Idioma:
spa
OAI Identifier:
oai:repository.unilibre.edu.co:10901/17732
Acceso en línea:
https://hdl.handle.net/10901/17732
Palabra clave:
Protocolo Fast Track
Colecistectomía laparoscópica
Cirugía
Fast-Track Surgery Protocol
Cholecystectomy
Gallbladder Surgery
Ambulatory surgery
Laparoscopy
Colecistectomia laparoscópica
Cirugía de la vesícula biliar
Cirugía ambulatoria
Protocolo Fast-Track Surgery
Colecistectomia
Laparoscopia
Cirugía de la vesícula biliar
Cirugía ambulatoria
Rights
openAccess
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.title.spa.fl_str_mv Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
title Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
spellingShingle Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
Protocolo Fast Track
Colecistectomía laparoscópica
Cirugía
Fast-Track Surgery Protocol
Cholecystectomy
Gallbladder Surgery
Ambulatory surgery
Laparoscopy
Colecistectomia laparoscópica
Cirugía de la vesícula biliar
Cirugía ambulatoria
Protocolo Fast-Track Surgery
Colecistectomia
Laparoscopia
Cirugía de la vesícula biliar
Cirugía ambulatoria
title_short Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
title_full Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
title_fullStr Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
title_full_unstemmed Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
title_sort Tiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminar
dc.creator.fl_str_mv Calderon Pacheco, Luis Miguel
Saldarriaga Pedroza, Luis Guillermo
dc.contributor.advisor.none.fl_str_mv Álvarez Jiménez, Jarib
Iglesias Acosta, Jesús
dc.contributor.author.none.fl_str_mv Calderon Pacheco, Luis Miguel
Saldarriaga Pedroza, Luis Guillermo
dc.subject.spa.fl_str_mv Protocolo Fast Track
Colecistectomía laparoscópica
Cirugía
topic Protocolo Fast Track
Colecistectomía laparoscópica
Cirugía
Fast-Track Surgery Protocol
Cholecystectomy
Gallbladder Surgery
Ambulatory surgery
Laparoscopy
Colecistectomia laparoscópica
Cirugía de la vesícula biliar
Cirugía ambulatoria
Protocolo Fast-Track Surgery
Colecistectomia
Laparoscopia
Cirugía de la vesícula biliar
Cirugía ambulatoria
dc.subject.subjectenglish.spa.fl_str_mv Fast-Track Surgery Protocol
Cholecystectomy
Gallbladder Surgery
Ambulatory surgery
Laparoscopy
dc.subject.lemb.spa.fl_str_mv Colecistectomia laparoscópica
Cirugía de la vesícula biliar
Cirugía ambulatoria
dc.subject.proposal.spa.fl_str_mv Protocolo Fast-Track Surgery
Colecistectomia
Laparoscopia
Cirugía de la vesícula biliar
Cirugía ambulatoria
description Estadísticamente la colecistectomia es el segundo procedimiento quirúrgico abdominal de urgencia mas realizado en todos los hospitales del mundo y el primero en el ambiente de la cirugía programada; conociendo estos datos, se diseño un protocolo Fast-Track Surgery con el fin de brindarle al paciente una recuperación mas rápida y oportuna, una reincorporación temprana a sus actividades y la descongestión de los servicios de hospitalización de la instituciones de salud. Cuando se mide el resultado final de una cirugía, habitualmente se analizan la morbilidad, la mortalidad, la estancia hospitalaria, el período total de reposo antes de volver al trabajo o a la actividad habitual previa, entre otros indicadores. Pues bien, estos parámetros se relacionan con la técnica quirúrgica, con la cantidad de pacientes atendidos en un determinado hospital para un procedimiento específico y con los procesos que utiliza cada institución; todo ello está modificándose de modo vertiginoso. Muchos de los procedimientos hoy se efectúan por la vía de la cirugía mínimamente invasiva y, por otro lado, la derivación de pacientes, ha hecho que ciertos centros adquieran más experiencia seguridad en sus prácticas, obteniendo mejores resultados. La aplicación del protocolo Fast-Track Surgery o rehabilitación multimodal en pacientes candidatos a cirugía de vesícula biliar por colecistitis Tokio I mejoraría los resultados con respecto a estancia hospitalaria, manejo del dolor posquirúrgico y satisfacción del paciente con relación a los obtenidos con los protocolos regulares? Haciendonos esta pregunta, desarrollamos un protocolo que evalua la que abarca los periodos prequirurgico, transquirurgico y postquirurgico donde se instauran medidas comunes para la recuperacion del los pacientes en un tiempo promedio de 6 horas al terminar el procedimiento quirurgico para asi orientar un egreso temprano y mejorar asi los servicios de salud en cuanto a la disponibilidad del servicio.
publishDate 2018
dc.date.created.none.fl_str_mv 2018
dc.date.accessioned.none.fl_str_mv 2020-01-14T15:06:42Z
dc.date.available.none.fl_str_mv 2020-01-14T15:06:42Z
dc.type.local.spa.fl_str_mv Tesis de Especialización
dc.type.hasversion.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/bachelorThesis
format http://purl.org/coar/resource_type/c_7a1f
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/10901/17732
dc.identifier.instname.spa.fl_str_mv instname:Universidad Libre
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad Libre
url https://hdl.handle.net/10901/17732
identifier_str_mv instname:Universidad Libre
reponame:Repositorio Institucional Universidad Libre
dc.language.iso.none.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv De Lathouwer C, Poullier JP. How much ambulatory surgery in the World in 1996-1997 and trends? Ambulatory surgery. 2000;8:191-210.
Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997; 78:606–617.
Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003; 362:1921–1928.
White PF, Kehlet H, Neal JM, et al. The role of the anesthesiologist in fasttrack surgery: from multimodal analgesia to perioperative medical care. AnesthAnalg 2007; 104:1380–1396.
Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 2008; 248:189–198.
Khuri SF, Henderson WG, Daley J, et al. The patient safety in surgery study: background, study design, and patien tpopulations. J Am CollSurg. 2007;204:1089 –1102.
Katchko K, Verhaalen A, Bruce M, Webb T. Cost Effectiveness of a Fast Track Protocol for Urgent Laparoscopic Cholecystectomies and Appendectomies. World J Surg (2016) 40:856–862
Tiwari M, Reynoso J, Tsang A, Oleynikov D. Comparison of Outcomes of Laparoscopic and Open Appendectomy in Management of Uncomplicated and Complicated Appendicitis. Ann Surg 2011;254:927–932
Barbadoro P, Marmorale C, Recanatini C, Mazzarini G, Pellegrini I, D’Errico M, Prospero E. May the drain be a way in for microbes in surgical infections?. American Journal of Infection Control 44 (2016) 283-8
Kerger K, Mascha E, Steinbrecher B, Frietsch T, Radke O, Stoecklein K, Frenkel C, Fritz G,Danner K, Turan A, Apfel C. Routine Use of Nasogastric Tubes Does Not Reduce Postoperative Nausea and Vomiting. Anesthesia& Analgesia. 109(3):768-773, September 2009
Bhat A, Parray F, Chowdri N, Wani R, Thakur N, Nazki S, Wani I. Mechanical bowel preparation versus no preparation in elective colorectal surgery: A prospective randomized study. International Journal of Surgery Open 2 (2016) 26–30
Bhat A, Parray F, Chowdri N, Wani R, Thakur N, Nazki S, Wani I. Mechanical bowel preparation versus no preparation in elective colorectal surgery: A prospective randomized study. International Journal of Surgery Open 2 (2016) 26–30
Rodríguez-Caravaca G, Gil-Yonte P, Risco-Risco C, Latasa Zamalloa P, Villar del Campo M, Fernández-Cebrián J, Valverde-Núñez I, and Lucendo 40 A. Antibiotic prophylaxis in elective cholecystectomy: Protocol adequacy and related outcomes in a retrospective single-centre analysis. Rev Esp Enferm Dig (Madrid) Vol. 108, N.º 1, pp. 15-19, 2016.
Bartlett M, Mauck K, Daniels P. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vascular Health and Risk Management 2015:11
Casans Francés R, Ripollés Melchor J, Abad-Gurumeta J, LongásValién J. Calvo Vecino J. El rol del anestesiólogo dentro de los programas de recuperación intensificada. RevEspAnestesiolReanim. 2016;63(5):273---288
Berberat PO, Ingold H, Gulbinas A, Kleeff J. Fast track- different implications in pancreatic surgery. J GastrointestSurg 2007; 11: 880-887
Van Dam RM, Hendry PO, Coolsen MME, Bemelmans MHA. Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection. Br J Surg 2008; 95: 969-975
DouglasW.Wilmore,MD.From Cuthbertson to Fast-TrackSurgery:70 
Years of Progress in Reducing Stress in Surgical Patients. Ann Surg 
2002;236(5):643–648.
MattiasSoop, Nygren J. Ljungqvist O. Optimizing perioperative management of patients undergoing colorectal surgery: what is new?. CurrOpinCritCare 2006;12:166–170.
Lassen, K; Hannemann, P; Ljungqvist, O; Fearon, K; et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005;330;1420-1421; Wilmore, D; Kehlet, H. Recent advances: Management of patients in fast track surgery. BMJ 2001;322;473-
Windl, J.; Polle, SW; FungKonJin, P; Dejong, C; et al. Systematic review of enhanced recovery programmes in colonic surgery. BJS 2006;93:800–80
Fanning, F; Andrews, DO and S.Early postoperative feeding after major gynecologic surgery: Evidence-basedscientific medicine. Am J Obstet Gynecol 2001;185:1-4
Rodi, S; Grau, M; Orsini, C. Evaluation of a Fast Track Unit: Alignment of Resources and Demand Results in Improved Satisfaction and Decreased Length of Stay for Emergency Department Patients. Quality management in healthcare 2006;15(3) 163-70
Taguchi, A; Sharma, N; Saleem, RM; Sessler, D. Et al. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med 2001;345(13):935-40
Basse L; Thorbol JE; Lossl K; Kehlet H. Colonic Surgery With Accelerated Rehabilitation or Conventional Care. Dis Colon Rectum 2004;47(3):271-8
Kehlet, H; Wilmore, DW. Fast-track surgery. BJS 2005; 92: 3–4
Reissman, P; Teoh, TA; Cohen, S; Weiss, E. et al. IsEarly Oral Feeding Safe After Elective Colorectal Surgery?. A Prospective Randomized Trial. Ann Surg 1995;222(1):73-7
Delaney, C; Zutshi, M; Senagore, A. Remzi, F. et al. Prospective, Randomized, Controlled Trial Between a Pathway of Controlled Rehabilitation With Early Ambulation and Diet and Traditional Postoperative Care After Laparotomy and Intestinal Resection. DisColon Rectum 2003; 46(7):851-9.
Wilmore, D; Kehlet, H. Recentadvances: Management of patients in fast track surgery. BMJ 2001;322;473-476
Joshi, G. Intraoperative Fluid Restriction Improves Outcome After Major Elective Gastrointestinal Surgery. AnesthAnalg 2005;101:601–5.
Toulson MI, CorreiaD,Gomes da Silva R. The impact of early nutrition
on metabolic response and postoperative ileus. Current Opinion in 
Clinical Nutrition and Metabolic Care 2004;7:577–583.
Fearon, KC; Ljungqvist O; Von Meyenfeldt M. Revhaug A; et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clinical Nutrition 2005;24(3):466-77.
DiFronzo, LA;. Yamin, N; Patel, K; O'Connell, T; Benefits of early feeding and early hospital discharge in elderly patients undergoing open colon resection. Journal of the American College of Surgeons 2003;197(5):747-52.
Brodner, G; Van Aken, H; Hertle, L; Fobker, M; et al. Multimodal Perioperative Management—CombiningThoracic Epidural Analgesia, Forced Mobilization, and Oral Nutrition—Reduces Hormonal and Metabolic Stress and Improves Convalescence After Major Urologic Surgery. AnesthAnalg 2001;92:1594-1600.
Basse, L; Jakobsen, DH; Billesbolle, P; Werner, M; et al. A Clinical Pathway to Accelerate Recovery After Colonic Resection. Ann. Surg. 2000;232(1):51–57
Basse, L; Raskov, H; Jakobsen, DH; Sonne, E; et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. BJS 2002;89:446-453
Mattei, P; Rombeau, J. Review of the Pathophysiology and Management of Post operative Ileus. World J Surg 2006;30:1382–1391.
Gatt, M; Anderson, DG; Reddy, BS; Hayward-Sampson, O; et al. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection. BJS 2005; 92:1354– 1362
Anderson, AD; McNaught, CE; MacFie, J; Tring, I; et al. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. BJS 2003;90:1497–1504.
Raue, W; Haase, O; Junghans, T; Scharfenberg, M; et al. Fast-track' multimodal rehabilitation program improves out come after laparoscopic sigmoidectomy: a controlled prospective evaluation. Surgical Endoscopy 2004;18(10):1463-8.
Bradshaw, B G; Liu, S S; Thirlby, RC. Standardized perioperative care protocols and reduced length of stay after colon surgery. Journal of the American College of Surgeons 1998;186(5):501-6.
Basse, L; Thorbol, JE; Lossl, K; Kehlet, H. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum 2004;47(3):271-7.
Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg 2002;183(6):630-41
Kehlet, H. Manipulation of the metabolic response in clinical practice. WorldJournal of Surgery 2000;24(6):690-5.
Rodgers, A; Walker, N; McKee, A.; Kehlet, H; et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomized trials. BMJ 2000;321(16):1493-6.
Waldhausen, J; Schirmer, B. The Effect of Ambulation on Recovery from Postoperative Ileus. Ann Surg1990;212(6):671-7.
Wolff, B; Michelassi, F; Gerkin, T; Techner, L. Alvimopan, a Novel, Peripherally Acting Opioid Antagonist. Ann Surg 2004;240: 4 728– 735.
Braga, M; Gianotti, L; Gentilini, O, Liotta, S; et al. Feeding the gut early after digestive surgery: results of a nine-year experience. ClinicalNutrition 2002;21(1):59-65.
Lewis, S; Egger, M; Sylvester, P; Thomas, S. Early enteral feeding versus “nilbymouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001;323:773–6
De Aguilar-Nascimento, JE; Göelzer, J. Early feeding after intestinal anastomoses: Risks or Benefits?. Revassocmedbras 2002; 48(4): 348-52
Watters, J; Kirkpatrick, S; Norris,N; Shamji, F; et al. Immediate Postoperative Enteral Feeding Results in Impaired Respiratory Mechanics and Decreased Mobility. Ann Surg 1997; 226(3)369-380.
Omura, K; Hirano, K; Kanehira, E; Kaito, K. et al. Small Amount of Low- Residue Diet with Parenteral Nutrition Can Prevent Decreases in Intestinal Mucosal Integrity. Ann Surg 2000;231(1):112–118.
Nygren, J; Thorell, A; Ljungqvist, O. Preoperative oral carbohydrate nutrition: an update. Current Opinion in Clinical Nutrition and Metabolic Care 2001, 4:255-9.
Jeffery, K M; Harkins, B; Cresci, G A; Martindale, RG. The clear liquid diet is no longer a necessity in the routine post operative management of surgical patients. American Surgeon 1996;62(3):167- 70.
Hancock, S; Cresci, G; Martindale, R. The clear liquid diet: when is it appropriate?. Current Gastroenterology Reports 2002;4(4):324-31
Ljungqvist, O; Nygren, J; Soop, M; Thorell, A. Metabolic perioperative management: novel concepts. CurrOpinCritCare 2005;11:295-299.
Nygren, J; Thorell, A; Ljungqvist, O. Preoperative oral carbohydrate nutrition: an up date. Current Opinion in Clinical Nutrition and Metabolic Care 2001,4:255-259.

Soop, M; Nygren, J; Myrenfors, P; Thorell, A; et al. Preoperative oral carbohydrate treatment attenuates Inmediate postoperative insulin resistance. Am J PhysiolEndocrinolMetab 2001;280:576-583.
Luckey, A;Livingston, E; Tache, Y. Mechanisms and Treatment of PostoperativeI leus. ArchSurg. 2003;138:206-214.
Bufo AAJ, Feldman S, Daniels GA, Lieberman RC. Early postoperative feeding. Dis Colon Rectum 1994; 37:1260–1265
Nelson, R; Tse, B; Edwards, S. Systematic review of prophylactic nasogastric decompression after abdominal operations. BJS 2005; 92: 673–680
Nelson, R; Edwards, S; Tse, B. Prophylactic nasogastric decompression after abdominal surgery. The Cochrane Library 2006; Volumen 2
Nygren, J; Thorell, A; Ljungqvist, O. New developments facilitating nutritional intake after gastrointestinal surgery. Current Opinion in Clinical Nutrition and Metabolic Care 2003, 6:593–597
Cheatham, M; Chapman, W; Key, S; Sawyers, J. A Meta-Analysis of Selective Versus Routine Nasogastric Decompression After Elective Laparotomy. Ann Surg 1995;221(5):469-478.
Schuster;R; Grewal,N; Greaney, G; Waxman, K. Gum Chewing Reduces Ileus After Elective Open Sigmoid Colectomy. ArchSurg. 2006;141:174-176.
Asao, T.; Kuwano, H; Nakamura, J; Morinaga, N; et al. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Journal of the American College of Surgeons 2002;195(1):30-2.
Rosado R, Medina P , Mezquita S, Gallardo A, Huertas, Ramírez D, Perales P, Redondo JA. Fast-track o cirugía mayor ambulatoria en la colecistectomía laparoscópica. ¿Ha cambiado algo?. Cir Esp. 2007;82(1):51-7.
Kehlet H. Future perspectives and research initiatives in fast-track surgery. LangenbecksArchSurg (2006) 391:495–498.
Jackson SA, Laurence AS, Hill JC. Does postlaparoscopy pain relate to residual carbon dioxide. Anaesthesia. 1996;5:485–7.
Wills Vl, Hunt DR. Pain after laparoscopic cholecystectomy. Br J Surg. 2000;87:273–84
Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg. 2001;167: 84–96.
Papagiannopoulou P, Argiriadou H, Georgiou M, Papaziogas B, Sfyra E, Kanakoudis F. Preincisional local infiltration of levobupivacaine vs ropivacaine for pain control alter laparoscopic cholecystectomy. Surg Endosc. 2003;17:1961–4.
Labaille T, Mazoit JX, Pauqeron X, Franco D, Benhamou D. The clinical efficacy and pharmacolinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg. 2002;94:100–5.
Kucuk C, Kadiogullari N, Canoler O, Savli S. A placebocontrolled comparison of bupivacaine and ropivacaine instillation for preventing postoperative pain alter laparoscopic cholecystectomy. Surg Today. 2007;37:396–400.
Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nin˜ as K, Manataki A, Tsimoyiannis EC. Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief alter laparoscopic cholecystectomy: a randomized double-blind controlledtrial. Surg Endosc. 2008;22:2036–45
Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg. 1990;160:485–7.
Martınez A, Docobo F, Mena J, Duran I, Vazquez J, Lopez F, et al. Colecistectomıa laparoscopica en el tratamiento de la litiasis biliar: ? cirugia mayor ambulatoria o corta estancia. Rev Esp Enferm Dig. 2004;96:452–9.
Bermudez I, Lopez S, Sanmillan A, Gonzalez C, Baamonde de la Torre I, Rodrıguez A, et al. Colecistectomıa laparoscopica en regimen ambulatorio. Cir Esp. 2004;76:159–63.
Serralta A, Garcıa Espinosa R, Martınez Casan P, Hoyas L, Planells M. Cuatro años de experiencia en colecistectomı´a laparoscopica ambulatoria. Rev Esp Enferm Dig. 2001;93: 207–10.
Bueno Lledo J, Planells Roig M, Arnau Bertomeu C, Sanahuja Santafe A, Oviedo Bravo M, Garcia Espinosa R, et al. Colecistectomia laparoscopica ambulatoria? El nuevo goldstandard de la colecistectomia? Rev Esp Enferm Dig. 2006;98:19–24.
Planells Roig M, Garcia Espinosa R, Cervera Delgado M, Navarro Vicente F, Carrau Giner M, Sanahuja Santafe A, et al. Ambulatory laparoscopic cholecystectomy. A cohort study of 1,600 consecutive cases. Cir Esp. 2013;91:156–62.
Ji W, Ding K, Yang R, Liu XD, Li N, Li JS. Outpatient singleincision laparoscopic cholecystectomy in 22 patients with gallbladder disease. Hepatobiliary Pancreat Dis Int. 2010;9:629–33.
Martın Fernandez J, Jara Sanchez A, Manzanares Campillo MC, Menendez Sanchez P, Muñoz Atienza V, Padilla Valverde D, et al. Single port laparoscopic cholecystectomy in major ambulatory surgery (MAS). Cir Esp. 2010;88:328–31.
Akoh JA, Watson WA, Bourne TP. Day case laparoscopic cholecystectomy: Reducing the admission rate. Int J Surg. 2011;9:63–7.
Lezana Perez MA, Carreño Villarreal G, Fresnedo Perez R, Lora Cumplido P, Padın Alvarez H, Alvarez Obregon R. Laparoscopic cholecystectomy performed as ambulatory major surgery in a regional hospital. Initial results of a series of 110 cases. Cir Esp. 2010;87:288–92
Herrero Fonollosa E, Cugat Andorra E, Garcıa Domingo MI, Camps Lasa J, Porta Castejon R, Carvajal Lopez F, et al. A randomised prospective comparative study between laparoscopic cholecystectomy and single port cholecystectomy in a major outpatient surgery unit. Cir Esp. 2012;90:641–6
Ahn Y, Woods J, Connor S. A systematic review of interventions to facilitate ambulatory laparoscopic cholecystectomy. HPB (Oxford). 2011;13:677–86.
Ji W, Ding K, Li LT, Wang D, Li N, Li JS. Outpatient versus inpatient laparoscopic cholecystectomy: A single center clinical analysis. Hepatobiliary Pancreat Dis Int. 2010;9:60–4
Morales Garcıa D, Martın Oviedo J, Garcıa Somacarrera E, Naranjo Gomez A. Why is it so difficult to integrate laparoscopic cholecystectomy as routine major ambulatory surgery? Cir Esp. 2009;86:122
Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg. 2001;167: 84–96
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spelling Álvarez Jiménez, JaribIglesias Acosta, JesúsCalderon Pacheco, Luis MiguelSaldarriaga Pedroza, Luis GuillermoBarranquilla2020-01-14T15:06:42Z2020-01-14T15:06:42Z2018https://hdl.handle.net/10901/17732instname:Universidad Librereponame:Repositorio Institucional Universidad LibreEstadísticamente la colecistectomia es el segundo procedimiento quirúrgico abdominal de urgencia mas realizado en todos los hospitales del mundo y el primero en el ambiente de la cirugía programada; conociendo estos datos, se diseño un protocolo Fast-Track Surgery con el fin de brindarle al paciente una recuperación mas rápida y oportuna, una reincorporación temprana a sus actividades y la descongestión de los servicios de hospitalización de la instituciones de salud. Cuando se mide el resultado final de una cirugía, habitualmente se analizan la morbilidad, la mortalidad, la estancia hospitalaria, el período total de reposo antes de volver al trabajo o a la actividad habitual previa, entre otros indicadores. Pues bien, estos parámetros se relacionan con la técnica quirúrgica, con la cantidad de pacientes atendidos en un determinado hospital para un procedimiento específico y con los procesos que utiliza cada institución; todo ello está modificándose de modo vertiginoso. Muchos de los procedimientos hoy se efectúan por la vía de la cirugía mínimamente invasiva y, por otro lado, la derivación de pacientes, ha hecho que ciertos centros adquieran más experiencia seguridad en sus prácticas, obteniendo mejores resultados. La aplicación del protocolo Fast-Track Surgery o rehabilitación multimodal en pacientes candidatos a cirugía de vesícula biliar por colecistitis Tokio I mejoraría los resultados con respecto a estancia hospitalaria, manejo del dolor posquirúrgico y satisfacción del paciente con relación a los obtenidos con los protocolos regulares? Haciendonos esta pregunta, desarrollamos un protocolo que evalua la que abarca los periodos prequirurgico, transquirurgico y postquirurgico donde se instauran medidas comunes para la recuperacion del los pacientes en un tiempo promedio de 6 horas al terminar el procedimiento quirurgico para asi orientar un egreso temprano y mejorar asi los servicios de salud en cuanto a la disponibilidad del servicio.Statistically, cholecystectomy is the second most urgent abdominal surgical procedure in all hospitals in the world and the first in the environment of scheduled surgery; Knowing these data, a Fast-Track Surgery protocol was designed in order to provide the patient with a faster and more timely recovery, an early return to their activities and the decongestion of hospitalization services of health institutions. When measuring the final result of surgery, morbidity, mortality, hospital stay, the total rest period before returning to work or previous usual activity, among other indicators, are usually analyzed. Well, these parameters are related to the surgical technique, with the number of patients treated in a given hospital for a specific procedure and with the processes used by each institution; All this is changing in a dizzying way. Many of the procedures are performed today through minimally invasive surgery and, on the other hand, the referral of patients, has made certain centers gain more experience in their practices, obtaining better results. The application of the Fast-Track Surgery protocol or multimodal rehabilitation in patients candidates for gallbladder surgery for cholecystitis Tokyo I would improve the results regarding hospital stay, post-surgical pain management and patient satisfaction in relation to those obtained with regular protocols? By asking ourselves this question, we developed a protocol that evaluates the one that covers the pre-surgical, trans-surgical and post-surgical periods where common measures are established for the recovery of patients in an average time of 6 hours at the end of the surgical procedure to guide an early discharge and improve thus the health services regarding the availability of the service.PDFapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiainfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Protocolo Fast TrackColecistectomía laparoscópicaCirugíaFast-Track Surgery ProtocolCholecystectomyGallbladder SurgeryAmbulatory surgeryLaparoscopyColecistectomia laparoscópicaCirugía de la vesícula biliarCirugía ambulatoriaProtocolo Fast-Track SurgeryColecistectomiaLaparoscopiaCirugía de la vesícula biliarCirugía ambulatoriaTiempo de hospitalizacion según protocolo Fast Track en colecistitis Tokio I informe preliminarTesis de Especializacióninfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisDe Lathouwer C, Poullier JP. How much ambulatory surgery in the World in 1996-1997 and trends? Ambulatory surgery. 2000;8:191-210.Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997; 78:606–617.Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003; 362:1921–1928.White PF, Kehlet H, Neal JM, et al. The role of the anesthesiologist in fasttrack surgery: from multimodal analgesia to perioperative medical care. AnesthAnalg 2007; 104:1380–1396.Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 2008; 248:189–198.Khuri SF, Henderson WG, Daley J, et al. The patient safety in surgery study: background, study design, and patien tpopulations. J Am CollSurg. 2007;204:1089 –1102.Katchko K, Verhaalen A, Bruce M, Webb T. Cost Effectiveness of a Fast Track Protocol for Urgent Laparoscopic Cholecystectomies and Appendectomies. World J Surg (2016) 40:856–862Tiwari M, Reynoso J, Tsang A, Oleynikov D. Comparison of Outcomes of Laparoscopic and Open Appendectomy in Management of Uncomplicated and Complicated Appendicitis. Ann Surg 2011;254:927–932Barbadoro P, Marmorale C, Recanatini C, Mazzarini G, Pellegrini I, D’Errico M, Prospero E. May the drain be a way in for microbes in surgical infections?. American Journal of Infection Control 44 (2016) 283-8Kerger K, Mascha E, Steinbrecher B, Frietsch T, Radke O, Stoecklein K, Frenkel C, Fritz G,Danner K, Turan A, Apfel C. Routine Use of Nasogastric Tubes Does Not Reduce Postoperative Nausea and Vomiting. Anesthesia& Analgesia. 109(3):768-773, September 2009Bhat A, Parray F, Chowdri N, Wani R, Thakur N, Nazki S, Wani I. Mechanical bowel preparation versus no preparation in elective colorectal surgery: A prospective randomized study. International Journal of Surgery Open 2 (2016) 26–30Bhat A, Parray F, Chowdri N, Wani R, Thakur N, Nazki S, Wani I. Mechanical bowel preparation versus no preparation in elective colorectal surgery: A prospective randomized study. International Journal of Surgery Open 2 (2016) 26–30Rodríguez-Caravaca G, Gil-Yonte P, Risco-Risco C, Latasa Zamalloa P, Villar del Campo M, Fernández-Cebrián J, Valverde-Núñez I, and Lucendo 40 A. Antibiotic prophylaxis in elective cholecystectomy: Protocol adequacy and related outcomes in a retrospective single-centre analysis. Rev Esp Enferm Dig (Madrid) Vol. 108, N.º 1, pp. 15-19, 2016.Bartlett M, Mauck K, Daniels P. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vascular Health and Risk Management 2015:11Casans Francés R, Ripollés Melchor J, Abad-Gurumeta J, LongásValién J. Calvo Vecino J. El rol del anestesiólogo dentro de los programas de recuperación intensificada. RevEspAnestesiolReanim. 2016;63(5):273---288Berberat PO, Ingold H, Gulbinas A, Kleeff J. Fast track- different implications in pancreatic surgery. J GastrointestSurg 2007; 11: 880-887Van Dam RM, Hendry PO, Coolsen MME, Bemelmans MHA. Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection. Br J Surg 2008; 95: 969-975DouglasW.Wilmore,MD.From Cuthbertson to Fast-TrackSurgery:70 
Years of Progress in Reducing Stress in Surgical Patients. Ann Surg 
2002;236(5):643–648.MattiasSoop, Nygren J. Ljungqvist O. Optimizing perioperative management of patients undergoing colorectal surgery: what is new?. CurrOpinCritCare 2006;12:166–170.Lassen, K; Hannemann, P; Ljungqvist, O; Fearon, K; et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005;330;1420-1421; Wilmore, D; Kehlet, H. Recent advances: Management of patients in fast track surgery. BMJ 2001;322;473-Windl, J.; Polle, SW; FungKonJin, P; Dejong, C; et al. Systematic review of enhanced recovery programmes in colonic surgery. BJS 2006;93:800–80Fanning, F; Andrews, DO and S.Early postoperative feeding after major gynecologic surgery: Evidence-basedscientific medicine. Am J Obstet Gynecol 2001;185:1-4Rodi, S; Grau, M; Orsini, C. Evaluation of a Fast Track Unit: Alignment of Resources and Demand Results in Improved Satisfaction and Decreased Length of Stay for Emergency Department Patients. Quality management in healthcare 2006;15(3) 163-70Taguchi, A; Sharma, N; Saleem, RM; Sessler, D. Et al. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med 2001;345(13):935-40Basse L; Thorbol JE; Lossl K; Kehlet H. Colonic Surgery With Accelerated Rehabilitation or Conventional Care. Dis Colon Rectum 2004;47(3):271-8Kehlet, H; Wilmore, DW. Fast-track surgery. BJS 2005; 92: 3–4Reissman, P; Teoh, TA; Cohen, S; Weiss, E. et al. IsEarly Oral Feeding Safe After Elective Colorectal Surgery?. A Prospective Randomized Trial. Ann Surg 1995;222(1):73-7Delaney, C; Zutshi, M; Senagore, A. Remzi, F. et al. Prospective, Randomized, Controlled Trial Between a Pathway of Controlled Rehabilitation With Early Ambulation and Diet and Traditional Postoperative Care After Laparotomy and Intestinal Resection. DisColon Rectum 2003; 46(7):851-9.Wilmore, D; Kehlet, H. Recentadvances: Management of patients in fast track surgery. BMJ 2001;322;473-476Joshi, G. Intraoperative Fluid Restriction Improves Outcome After Major Elective Gastrointestinal Surgery. AnesthAnalg 2005;101:601–5.Toulson MI, CorreiaD,Gomes da Silva R. The impact of early nutrition
on metabolic response and postoperative ileus. Current Opinion in 
Clinical Nutrition and Metabolic Care 2004;7:577–583.Fearon, KC; Ljungqvist O; Von Meyenfeldt M. Revhaug A; et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clinical Nutrition 2005;24(3):466-77.DiFronzo, LA;. Yamin, N; Patel, K; O'Connell, T; Benefits of early feeding and early hospital discharge in elderly patients undergoing open colon resection. Journal of the American College of Surgeons 2003;197(5):747-52.Brodner, G; Van Aken, H; Hertle, L; Fobker, M; et al. Multimodal Perioperative Management—CombiningThoracic Epidural Analgesia, Forced Mobilization, and Oral Nutrition—Reduces Hormonal and Metabolic Stress and Improves Convalescence After Major Urologic Surgery. AnesthAnalg 2001;92:1594-1600.Basse, L; Jakobsen, DH; Billesbolle, P; Werner, M; et al. A Clinical Pathway to Accelerate Recovery After Colonic Resection. Ann. Surg. 2000;232(1):51–57Basse, L; Raskov, H; Jakobsen, DH; Sonne, E; et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. BJS 2002;89:446-453Mattei, P; Rombeau, J. Review of the Pathophysiology and Management of Post operative Ileus. World J Surg 2006;30:1382–1391.Gatt, M; Anderson, DG; Reddy, BS; Hayward-Sampson, O; et al. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection. BJS 2005; 92:1354– 1362Anderson, AD; McNaught, CE; MacFie, J; Tring, I; et al. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. BJS 2003;90:1497–1504.Raue, W; Haase, O; Junghans, T; Scharfenberg, M; et al. Fast-track' multimodal rehabilitation program improves out come after laparoscopic sigmoidectomy: a controlled prospective evaluation. Surgical Endoscopy 2004;18(10):1463-8.Bradshaw, B G; Liu, S S; Thirlby, RC. Standardized perioperative care protocols and reduced length of stay after colon surgery. Journal of the American College of Surgeons 1998;186(5):501-6.Basse, L; Thorbol, JE; Lossl, K; Kehlet, H. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum 2004;47(3):271-7.Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg 2002;183(6):630-41Kehlet, H. Manipulation of the metabolic response in clinical practice. WorldJournal of Surgery 2000;24(6):690-5.Rodgers, A; Walker, N; McKee, A.; Kehlet, H; et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomized trials. BMJ 2000;321(16):1493-6.Waldhausen, J; Schirmer, B. The Effect of Ambulation on Recovery from Postoperative Ileus. Ann Surg1990;212(6):671-7.Wolff, B; Michelassi, F; Gerkin, T; Techner, L. Alvimopan, a Novel, Peripherally Acting Opioid Antagonist. Ann Surg 2004;240: 4 728– 735.Braga, M; Gianotti, L; Gentilini, O, Liotta, S; et al. Feeding the gut early after digestive surgery: results of a nine-year experience. ClinicalNutrition 2002;21(1):59-65.Lewis, S; Egger, M; Sylvester, P; Thomas, S. Early enteral feeding versus “nilbymouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001;323:773–6De Aguilar-Nascimento, JE; Göelzer, J. Early feeding after intestinal anastomoses: Risks or Benefits?. Revassocmedbras 2002; 48(4): 348-52Watters, J; Kirkpatrick, S; Norris,N; Shamji, F; et al. Immediate Postoperative Enteral Feeding Results in Impaired Respiratory Mechanics and Decreased Mobility. Ann Surg 1997; 226(3)369-380.Omura, K; Hirano, K; Kanehira, E; Kaito, K. et al. Small Amount of Low- Residue Diet with Parenteral Nutrition Can Prevent Decreases in Intestinal Mucosal Integrity. Ann Surg 2000;231(1):112–118.Nygren, J; Thorell, A; Ljungqvist, O. Preoperative oral carbohydrate nutrition: an update. Current Opinion in Clinical Nutrition and Metabolic Care 2001, 4:255-9.Jeffery, K M; Harkins, B; Cresci, G A; Martindale, RG. The clear liquid diet is no longer a necessity in the routine post operative management of surgical patients. American Surgeon 1996;62(3):167- 70.Hancock, S; Cresci, G; Martindale, R. The clear liquid diet: when is it appropriate?. Current Gastroenterology Reports 2002;4(4):324-31Ljungqvist, O; Nygren, J; Soop, M; Thorell, A. Metabolic perioperative management: novel concepts. CurrOpinCritCare 2005;11:295-299.Nygren, J; Thorell, A; Ljungqvist, O. Preoperative oral carbohydrate nutrition: an up date. Current Opinion in Clinical Nutrition and Metabolic Care 2001,4:255-259.
Soop, M; Nygren, J; Myrenfors, P; Thorell, A; et al. Preoperative oral carbohydrate treatment attenuates Inmediate postoperative insulin resistance. Am J PhysiolEndocrinolMetab 2001;280:576-583.Luckey, A;Livingston, E; Tache, Y. Mechanisms and Treatment of PostoperativeI leus. ArchSurg. 2003;138:206-214.Bufo AAJ, Feldman S, Daniels GA, Lieberman RC. Early postoperative feeding. Dis Colon Rectum 1994; 37:1260–1265Nelson, R; Tse, B; Edwards, S. Systematic review of prophylactic nasogastric decompression after abdominal operations. BJS 2005; 92: 673–680Nelson, R; Edwards, S; Tse, B. Prophylactic nasogastric decompression after abdominal surgery. The Cochrane Library 2006; Volumen 2Nygren, J; Thorell, A; Ljungqvist, O. New developments facilitating nutritional intake after gastrointestinal surgery. Current Opinion in Clinical Nutrition and Metabolic Care 2003, 6:593–597Cheatham, M; Chapman, W; Key, S; Sawyers, J. A Meta-Analysis of Selective Versus Routine Nasogastric Decompression After Elective Laparotomy. Ann Surg 1995;221(5):469-478.Schuster;R; Grewal,N; Greaney, G; Waxman, K. Gum Chewing Reduces Ileus After Elective Open Sigmoid Colectomy. ArchSurg. 2006;141:174-176.Asao, T.; Kuwano, H; Nakamura, J; Morinaga, N; et al. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Journal of the American College of Surgeons 2002;195(1):30-2.Rosado R, Medina P , Mezquita S, Gallardo A, Huertas, Ramírez D, Perales P, Redondo JA. Fast-track o cirugía mayor ambulatoria en la colecistectomía laparoscópica. ¿Ha cambiado algo?. Cir Esp. 2007;82(1):51-7.Kehlet H. Future perspectives and research initiatives in fast-track surgery. LangenbecksArchSurg (2006) 391:495–498.Jackson SA, Laurence AS, Hill JC. Does postlaparoscopy pain relate to residual carbon dioxide. Anaesthesia. 1996;5:485–7.Wills Vl, Hunt DR. Pain after laparoscopic cholecystectomy. Br J Surg. 2000;87:273–84Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg. 2001;167: 84–96.Papagiannopoulou P, Argiriadou H, Georgiou M, Papaziogas B, Sfyra E, Kanakoudis F. Preincisional local infiltration of levobupivacaine vs ropivacaine for pain control alter laparoscopic cholecystectomy. Surg Endosc. 2003;17:1961–4.Labaille T, Mazoit JX, Pauqeron X, Franco D, Benhamou D. The clinical efficacy and pharmacolinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg. 2002;94:100–5.Kucuk C, Kadiogullari N, Canoler O, Savli S. A placebocontrolled comparison of bupivacaine and ropivacaine instillation for preventing postoperative pain alter laparoscopic cholecystectomy. Surg Today. 2007;37:396–400.Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nin˜ as K, Manataki A, Tsimoyiannis EC. Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief alter laparoscopic cholecystectomy: a randomized double-blind controlledtrial. Surg Endosc. 2008;22:2036–45Reddick EJ, Olsen DO. Outpatient laparoscopic laser cholecystectomy. Am J Surg. 1990;160:485–7.Martınez A, Docobo F, Mena J, Duran I, Vazquez J, Lopez F, et al. Colecistectomıa laparoscopica en el tratamiento de la litiasis biliar: ? cirugia mayor ambulatoria o corta estancia. Rev Esp Enferm Dig. 2004;96:452–9.Bermudez I, Lopez S, Sanmillan A, Gonzalez C, Baamonde de la Torre I, Rodrıguez A, et al. Colecistectomıa laparoscopica en regimen ambulatorio. Cir Esp. 2004;76:159–63.Serralta A, Garcıa Espinosa R, Martınez Casan P, Hoyas L, Planells M. Cuatro años de experiencia en colecistectomı´a laparoscopica ambulatoria. Rev Esp Enferm Dig. 2001;93: 207–10.Bueno Lledo J, Planells Roig M, Arnau Bertomeu C, Sanahuja Santafe A, Oviedo Bravo M, Garcia Espinosa R, et al. Colecistectomia laparoscopica ambulatoria? El nuevo goldstandard de la colecistectomia? Rev Esp Enferm Dig. 2006;98:19–24.Planells Roig M, Garcia Espinosa R, Cervera Delgado M, Navarro Vicente F, Carrau Giner M, Sanahuja Santafe A, et al. Ambulatory laparoscopic cholecystectomy. A cohort study of 1,600 consecutive cases. Cir Esp. 2013;91:156–62.Ji W, Ding K, Yang R, Liu XD, Li N, Li JS. Outpatient singleincision laparoscopic cholecystectomy in 22 patients with gallbladder disease. Hepatobiliary Pancreat Dis Int. 2010;9:629–33.Martın Fernandez J, Jara Sanchez A, Manzanares Campillo MC, Menendez Sanchez P, Muñoz Atienza V, Padilla Valverde D, et al. Single port laparoscopic cholecystectomy in major ambulatory surgery (MAS). Cir Esp. 2010;88:328–31.Akoh JA, Watson WA, Bourne TP. Day case laparoscopic cholecystectomy: Reducing the admission rate. Int J Surg. 2011;9:63–7.Lezana Perez MA, Carreño Villarreal G, Fresnedo Perez R, Lora Cumplido P, Padın Alvarez H, Alvarez Obregon R. Laparoscopic cholecystectomy performed as ambulatory major surgery in a regional hospital. Initial results of a series of 110 cases. Cir Esp. 2010;87:288–92Herrero Fonollosa E, Cugat Andorra E, Garcıa Domingo MI, Camps Lasa J, Porta Castejon R, Carvajal Lopez F, et al. A randomised prospective comparative study between laparoscopic cholecystectomy and single port cholecystectomy in a major outpatient surgery unit. Cir Esp. 2012;90:641–6Ahn Y, Woods J, Connor S. A systematic review of interventions to facilitate ambulatory laparoscopic cholecystectomy. HPB (Oxford). 2011;13:677–86.Ji W, Ding K, Li LT, Wang D, Li N, Li JS. Outpatient versus inpatient laparoscopic cholecystectomy: A single center clinical analysis. Hepatobiliary Pancreat Dis Int. 2010;9:60–4Morales Garcıa D, Martın Oviedo J, Garcıa Somacarrera E, Naranjo Gomez A. Why is it so difficult to integrate laparoscopic cholecystectomy as routine major ambulatory surgery? Cir Esp. 2009;86:122Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg. 2001;167: 84–96THUMBNAILInforme final.pdf.jpgInforme final.pdf.jpgIM Thumbnailimage/jpeg8414http://repository.unilibre.edu.co/bitstream/10901/17732/3/Informe%20final.pdf.jpgf03ae3e53a25634a4350aa322531eb3fMD53LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repository.unilibre.edu.co/bitstream/10901/17732/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52ORIGINALInforme final.pdfInforme final.pdfapplication/pdf1391837http://repository.unilibre.edu.co/bitstream/10901/17732/1/Informe%20final.pdfdc88df0d7f4953432a7f3a7f91859b8eMD5110901/17732oai:repository.unilibre.edu.co:10901/177322022-10-11 12:08:25.496Repositorio Institucional Unilibrerepositorio@unilibrebog.edu.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