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Anales de la Facultad de Ciencias Médicas (Asunción)
versão impressa ISSN 1816-8949
Resumo
ROJAS M, Rubén e SAMANIEGO A, Castor. Cancer of the goldbladder: the limitations in diagnosis and treatment. An. Fac. Cienc. Méd. (Asunción) [online]. 2005, vol.38, n.4, pp.73-79. ISSN 1816-8949.
Precedents: Gallbladder cancer has a low frequency in South America, except in Chile; generally it is diagnosed and treated in advanced stages. Objective: To study, demographic profile and presentation of patients with cancer of the gallbladder. Evaluation of the diagnostic possibilities and results of surgery. Material and method: descriptive and retrospective study based on patients subjected to colecistectomy for stones in the time period 1992-2002. The verified cases of cancer of gallbladder were selected. In these we evaluated: frequency, demographic profile, presentation, diagnostic methods and immediate results of the treatment. Result: 16 cases of gallbladder cancer on 3239 colecistectomies were found (0.5 %); 15 were women. The mean age was 63 years (r 53-77). The pain was the principal complaint. 75 % presented jaundice + coluria + acolia. The ultrasound scan verified thickening of the gallbladder wall in 6 cases and escleroatrofic gallbladder in one. Simple colecistectomy was carried out in 2 cases; it was associated with biliary external drainage in 3, hepatic biopsy in 2 and biliodigestiva divertion in 1; a biliodigestive divertion, two biliary external drainages, 4 biopsies and one endoscopic prosthesis complete the series. One patient presented a biliary-fistula. Five patients died (31 %): 4 for infectious complications with organic multiple failure and 1 of pulmonary tromboembolic. Conclusion: Gallbladder cancer is rare, prevails in the women and often presents with biliary obstruction. The diagnostic orientation is difficult with ultrasound scan; only a localized thickening coexistent with gallstones seems to be significant and mandates a frozer section biopsy.
Palavras-chave : cancer of the gallbladder.