{"id":2569,"date":"2022-08-25T08:00:00","date_gmt":"2022-08-25T11:00:00","guid":{"rendered":"https:\/\/gastropedia.pub\/pt\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/"},"modified":"2023-08-26T19:07:28","modified_gmt":"2023-08-26T22:07:28","slug":"microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/","title":{"rendered":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?"},"content":{"rendered":"
\"image_pdf\"<\/a>\"image_print\"<\/a><\/div>\n

A doen\u00e7a calculosa da ves\u00edcula biliar \u00e9 respons\u00e1vel por grande volume das cirurgias eletivas dentro do nosso sistema de sa\u00fade e as complica\u00e7\u00f5es da doen\u00e7a biliar geram in\u00fameros atendimentos e interna\u00e7\u00f5es de urg\u00eancia: colecistite aguda, pancreatite aguda biliar, coledocolit\u00edase<\/a> e colangite aguda.<\/p>\n\n\n\n

Nos Estados Unidos h\u00e1 dados que demonstram preval\u00eancia de colelit\u00edase de 6% na popula\u00e7\u00e3o masculina e 9% em pacientes do sexo feminino. H\u00e1 poucos estudos nacionais, cada um demonstrou preval\u00eancia vari\u00e1vel, mas todos acima de 5% da popula\u00e7\u00e3o brasileira e com predomin\u00e2ncia no sexo feminino. <\/p>\n\n\n\n

Dentre as suas formas de apresenta\u00e7\u00e3o, o barro biliar e a microlit\u00edase s\u00e3o achados menos frequentes e discute-se se seriam um passo intermedi\u00e1rio na forma\u00e7\u00e3o dos c\u00e1lculos biliares. Nesse artigo descreveremos seus conceitos e principais repercuss\u00f5es cl\u00ednicas.<\/p>\n\n\n\n

Barro Biliar<\/strong><\/h2>\n\n\n\n

O barro biliar \u00e9 mais comumente formada de cristais de colesterol a partir da estase biliar, mas sua composi\u00e7\u00e3o pode variar de acordo com a etiologia2<\/sup> (complexos de c\u00e1lcio-ceftriaxone, por exemplo).<\/p>\n\n\n\n

Frequentemente relatado em situa\u00e7\u00f5es espec\u00edficas<\/strong> que predisp\u00f5em estase biliar ou forma\u00e7\u00e3o de cristais como: nutri\u00e7\u00e3o parenteral, doentes cr\u00edticos, uso de ceftriaxone e gesta\u00e7\u00e3o como exemplos mais comuns. Nessas situa\u00e7\u00f5es, o barro biliar possui potencial revers\u00edvel e, caso paciente n\u00e3o apresente complica\u00e7\u00f5es da doen\u00e7a biliar, recomenda-se observa\u00e7\u00e3o at\u00e9 a retirada do fator causal.<\/p>\n\n\n\n

Descrito principalmente como um achado ultrassonogr\u00e1fico, a ves\u00edcula biliar apresenta um conte\u00fado hipoecog\u00eanico que se deposita formando n\u00edvel em rela\u00e7\u00e3o a bile mais flu\u00edda e sem formar sombra ac\u00fastica posterior. O barro biliar muda de posi\u00e7\u00e3o lentamente de acordo com o dec\u00fabito do paciente.<\/p>\n\n\n\n

\"\"
Figura 1<\/strong> \u2013 Ultrassonografia transabdominal demonstrando barro biliar hipoecog\u00eanico formando n\u00edvel conforme a gravidade, sem forma\u00e7\u00e3o de sombra ac\u00fastica posterior.<\/figcaption><\/figure>\n\n\n\n

Em estudos observacionais apresenta evolu\u00e7\u00e3o vari\u00e1vel, podendo regredir espontaneamente em at\u00e9 20% dos casos seguidos por 3 anos. Entretanto, em paciente eleg\u00edveis; recomenda-se o tratamento cir\u00fargico<\/strong> preferencialmente a colecistectomia videolaparosc\u00f3pica quando h\u00e1 sintomas compat\u00edveis com obstru\u00e7\u00e3o biliar ou se vig\u00eancia de doen\u00e7a biliar complicada.<\/p>\n\n\n\n

Microlit\u00edase<\/strong><\/h2>\n\n\n\n

\u00c9 definida como presen\u00e7a de c\u00e1lculos menores que 3 mm. Devido a suas dimens\u00f5es possui dif\u00edcil visualiza\u00e7\u00e3o via ultrassonografia transabdominal. Assim, situa\u00e7\u00f5es cl\u00ednicas de alta suspeita de lit\u00edase biliar com ultrassonografia transabdominal negativa podem ser melhor esclarecidas via ecoendoscopia<\/strong> (exame que pode chegar a sensibilidade de 95% para esse diagn\u00f3stico). 4<\/sup><\/p>\n\n\n\n

\"\"
Figura 2<\/strong> \u2013 Achado ecoendosc\u00f3pico de microlit\u00edase biliar \u2013 microc\u00e1lculos hiperecog\u00eanicos em suspens\u00e3o na ves\u00edcula biliar (aspecto de c\u00e9u estrelado).<\/figcaption><\/figure>\n\n\n\n

Como esse achado depende, muitas vezes, de um exame de alta complexidade e pouco dispon\u00edvel como a ecoendoscopia; a quase totalidade do casos de microlit\u00edase s\u00e3o de pacientes com sintomas de c\u00f3lica biliar ou ap\u00f3s doen\u00e7a biliar complicada. Al\u00e9m disso, acredita-se que os microc\u00e1lculos possuem um maior potencial de migra\u00e7\u00e3o devido \u00e0s suas dimens\u00f5es. Por isso, recomenda-se o tratamento cir\u00fargico<\/strong> preferencialmente a colecistectomia videolaparosc\u00f3pica<\/p>\n\n\n\n

Por fim, \u00e9 importante ressaltar que a literatura dispon\u00edvel para essas formas de apresenta\u00e7\u00e3o da doen\u00e7a calculosa da ves\u00edcula biliar \u00e9 focada em paciente sintom\u00e1ticos ou em investiga\u00e7\u00e3o etiol\u00f3gica de doen\u00e7a biliar complicada.  Dessa forma, onde se tem maior disponibilidade de exames no contexto de paciente assintom\u00e1tico, recomenda-se cautela frente a esses achados para n\u00e3o oferecermos procedimentos f\u00fateis ao paciente.<\/p>\n\n\n\n

Refer\u00eancias<\/h2>\n\n\n\n
\n
    \n
  1. Everhart, J. E., Khare, M., Hill, M. & Maurer, K. R. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology<\/em> 117<\/strong>, 632\u2013639 (1999).<\/li>\n\n\n\n
  2. Coelho, J. C., Bonilha, R., Pitaki, S.A., et al.<\/em> Prevalence of gallstones in a Brazilian Population. Int Surg. 84: 25-28 (1999).<\/li>\n\n\n\n
  3. Wang, H. H., Portincasa, P., Liu, M., Tso, P. & Wang, D. Q. H. Similarities and differences between biliary sludge and microlithiasis: Their clinical and pathophysiological significances. Liver Res.<\/em> 2<\/strong>, 186\u2013199 (2018).<\/li>\n\n\n\n
  4. Ko, C. W., Sekijima, J. H. & Lee, S. P. Biliary sludge. Ann. Intern. Med.<\/em> 130<\/strong>, 301\u2013311 (1999).<\/li>\n\n\n\n
  5. Dill, J. E. et al.<\/em> Combined Endoscopic Ultrasound and Stimulated Biliary Drainage in Cholecystitis and Microlithiasis – Diagnoses and Outcomes. Endoscopy<\/em> 27<\/strong>, 424\u2013427 (1995).<\/li>\n\n\n\n
  6. Lammert, F. et al.<\/em> EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J. Hepatol.<\/em> 65<\/strong>, 146\u2013181 (2016).<\/li>\n<\/ol>\n\n\n\n

    Como citar esse artigo<\/h2>\n\n\n\n

    Magalhaes, DP. Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica? Gastropedia, 2022. Dispon\u00edvel em: https:\/\/gastropedia\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/<\/a><\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

    A doen\u00e7a calculosa da ves\u00edcula biliar \u00e9 respons\u00e1vel por grande volume das cirurgias eletivas dentro do nosso sistema de sa\u00fade e as complica\u00e7\u00f5es da doen\u00e7a biliar geram in\u00fameros atendimentos e…<\/p>\n","protected":false},"author":5589,"featured_media":2568,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[24,28],"tags":[110,111],"ano":[43],"tipo":[121],"volume":[44],"class_list":["post-2569","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cirurgia","category-hepatopancreatobiliar","tag-barro-biliar","tag-microcalculos","ano-43","tipo-assuntos-gerais","volume-volume-ii"],"yoast_head":"\nMicroc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica? - Gastropedia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?\" \/>\n<meta property=\"og:description\" content=\"A doen\u00e7a calculosa da ves\u00edcula biliar \u00e9 respons\u00e1vel por grande volume das cirurgias eletivas dentro do nosso sistema de sa\u00fade e as complica\u00e7\u00f5es da doen\u00e7a biliar geram in\u00fameros atendimentos e…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/\" \/>\n<meta property=\"og:site_name\" content=\"Gastropedia\" \/>\n<meta property=\"article:published_time\" content=\"2022-08-25T11:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-26T22:07:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png\" \/>\n\t<meta property=\"og:image:width\" content=\"596\" \/>\n\t<meta property=\"og:image:height\" content=\"606\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Daniel de Paiva Magalh\u00e3es\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Daniel de Paiva Magalh\u00e3es\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/\"},\"author\":{\"name\":\"Daniel de Paiva Magalh\u00e3es\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/0152a7ff9ff5ff51124300d2fc71d48f\"},\"headline\":\"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?\",\"datePublished\":\"2022-08-25T11:00:00+00:00\",\"dateModified\":\"2023-08-26T22:07:28+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/\"},\"wordCount\":771,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/08\\\/image-4.png\",\"keywords\":[\"barro biliar\",\"microc\u00e1lculos\"],\"articleSection\":[\"Cirurgia\",\"Hepatopancreatobiliar\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/\",\"name\":\"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica? - Gastropedia\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/08\\\/image-4.png\",\"datePublished\":\"2022-08-25T11:00:00+00:00\",\"dateModified\":\"2023-08-26T22:07:28+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/0152a7ff9ff5ff51124300d2fc71d48f\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#primaryimage\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/08\\\/image-4.png\",\"contentUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/08\\\/image-4.png\",\"width\":596,\"height\":606},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/cirurgia\\\/hepatopancreatobiliar\\\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"In\u00edcio\",\"item\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\",\"name\":\"Gastropedia\",\"description\":\"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/0152a7ff9ff5ff51124300d2fc71d48f\",\"name\":\"Daniel de Paiva Magalh\u00e3es\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/?d=identicon&s=96\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/?d=identicon&s=96\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/?d=identicon&s=96\",\"caption\":\"Daniel de Paiva Magalh\u00e3es\"},\"description\":\"Resid\u00eancia m\u00e9dica em Cirurgia Geral e Cirurgia do Aparelho Digestivo pelo Hospital das Cl\u00ednicas da FMUSP. Cirurgi\u00e3o volunt\u00e1rio do Servi\u00e7o de P\u00e2ncreas e Vias Biliares do Hospital das Cl\u00ednicas - USP. Cirurgi\u00e3o do Aparelho Digestivo no Hospital Israelita Albert Einstein\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/author\\\/dpmagalhaes\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica? - Gastropedia","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/","og_locale":"pt_BR","og_type":"article","og_title":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?","og_description":"A doen\u00e7a calculosa da ves\u00edcula biliar \u00e9 respons\u00e1vel por grande volume das cirurgias eletivas dentro do nosso sistema de sa\u00fade e as complica\u00e7\u00f5es da doen\u00e7a biliar geram in\u00fameros atendimentos e…","og_url":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/","og_site_name":"Gastropedia","article_published_time":"2022-08-25T11:00:00+00:00","article_modified_time":"2023-08-26T22:07:28+00:00","og_image":[{"width":596,"height":606,"url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png","type":"image\/png"}],"author":"Daniel de Paiva Magalh\u00e3es","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Daniel de Paiva Magalh\u00e3es","Est. tempo de leitura":"5 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#article","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/"},"author":{"name":"Daniel de Paiva Magalh\u00e3es","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/0152a7ff9ff5ff51124300d2fc71d48f"},"headline":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?","datePublished":"2022-08-25T11:00:00+00:00","dateModified":"2023-08-26T22:07:28+00:00","mainEntityOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/"},"wordCount":771,"commentCount":0,"image":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png","keywords":["barro biliar","microc\u00e1lculos"],"articleSection":["Cirurgia","Hepatopancreatobiliar"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/","url":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/","name":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica? - Gastropedia","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#primaryimage"},"image":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png","datePublished":"2022-08-25T11:00:00+00:00","dateModified":"2023-08-26T22:07:28+00:00","author":{"@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/0152a7ff9ff5ff51124300d2fc71d48f"},"breadcrumb":{"@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#primaryimage","url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png","contentUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/08\/image-4.png","width":596,"height":606},{"@type":"BreadcrumbList","@id":"https:\/\/gastropedia.pub\/pt\/cirurgia\/hepatopancreatobiliar\/microcalculos-e-barro-biliar-quais-seus-valores-para-a-pratica-clinica\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"In\u00edcio","item":"https:\/\/gastropedia.pub\/pt\/"},{"@type":"ListItem","position":2,"name":"Microc\u00e1lculos e barro biliar \u2013 Quais seus valores para a pr\u00e1tica cl\u00ednica?"}]},{"@type":"WebSite","@id":"https:\/\/gastropedia.pub\/pt\/#website","url":"https:\/\/gastropedia.pub\/pt\/","name":"Gastropedia","description":"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/gastropedia.pub\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Person","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/0152a7ff9ff5ff51124300d2fc71d48f","name":"Daniel de Paiva Magalh\u00e3es","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/secure.gravatar.com\/avatar\/?d=identicon&s=96","url":"https:\/\/secure.gravatar.com\/avatar\/?d=identicon&s=96","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/?d=identicon&s=96","caption":"Daniel de Paiva Magalh\u00e3es"},"description":"Resid\u00eancia m\u00e9dica em Cirurgia Geral e Cirurgia do Aparelho Digestivo pelo Hospital das Cl\u00ednicas da FMUSP. Cirurgi\u00e3o volunt\u00e1rio do Servi\u00e7o de P\u00e2ncreas e Vias Biliares do Hospital das Cl\u00ednicas - USP. Cirurgi\u00e3o do Aparelho Digestivo no Hospital Israelita Albert Einstein","url":"https:\/\/gastropedia.pub\/pt\/author\/dpmagalhaes\/"}]}},"_links":{"self":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/2569","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/users\/5589"}],"replies":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/comments?post=2569"}],"version-history":[{"count":5,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/2569\/revisions"}],"predecessor-version":[{"id":7319,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/2569\/revisions\/7319"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media\/2568"}],"wp:attachment":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media?parent=2569"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/categories?post=2569"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tags?post=2569"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/ano?post=2569"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tipo?post=2569"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/volume?post=2569"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}