<?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>2307-0420</journal-id>
<journal-title><![CDATA[Cirugía paraguaya]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cir. Parag.]]></abbrev-journal-title>
<issn>2307-0420</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-04202016000200008</article-id>
<article-id pub-id-type="doi">10.18004/sopaci.noviembre.8-11</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[CÁNCER DE LA VESÍCULA BILIAR. EXPERIENCIA DE 10 AÑOS DEL INSTITUTO NACIONAL DEL CÁNCER]]></article-title>
<article-title xml:lang="en"><![CDATA[GALLBLADDER CARCINOMA. A 10 YEARS' EXPERIENCE AT NATIONAL CANCER INSTITUTE]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[Analía Soledad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Ehiser]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Román]]></surname>
<given-names><![CDATA[Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gamarra]]></surname>
<given-names><![CDATA[Elías]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalba]]></surname>
<given-names><![CDATA[William]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional del Cáncer  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional del Cáncer  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional del Cáncer  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Nacional del Cáncer  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>11</month>
<year>2016</year>
</pub-date>
<volume>40</volume>
<numero>2</numero>
<fpage>8</fpage>
<lpage>11</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-04202016000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-04202016000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-04202016000200008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN 36 casos de cáncer vesicular, 3,6 casos nuevos por año, 75% fueron mujeres. La edad media fue 59,5 años. Los factores de riesgo fueron litiasis vesicular en 87%, obesidad 8%, pólipo vesícula 2% y sin factor de riesgo 3%. Ninguno de los pacientes presento antecedentes patológicos familiares. El 100% los pacientes fueron inicialmente intervenidos en otros servicios quirúrgicos del país y luego fueron remitidos a nuestra institución para mejor tratamiento en dichos servicios. Se realizó colecistectomía simple en 26 casos, colecistectomía parcial en 2 casos, colecistectomía + drenaje externo en 3 de los casos, colecistectomía + biopsia ganglionar en 3 casos, y solo biopsia en 2 casos por enfermedad diseminada. El 14% de los pacientes presentó ictericia + coluria + acolia. La estatificación al ingreso fue un estadio IV b en un 83%, IV a 11 % y III b 6 %. A los resultados de anatomía patológica se pudo constatar que el adenocarcinoma predomino en 82% ante el carcinoma escamoso 12% y mal diferenciado 6%.El tratamiento propuesto por el equipo multidisciplinario ya en nuestra institución fue en 7 casos cirugía, quimioterapia exclusiva en 1 caso, quimioterapia paliativa en 5 pacientes, cuidados paliativos exclusivos en 18 casos. Vale la pena mencionar que 5 pacientes se negaron a tratamiento alguno solicitando el alta voluntaria. Cabe destacar que un paciente de la serie el cual recibió tratamiento quirúrgico (linfadenectomia radical+ resección hepática IV Y V) más quimioterapia y radioterapia adyuvante tuvo una sobrevida de 4 años, el resto de los pacientes ingresaron con mal pronóstico y la sobrevida promedio no fue más de 6 meses.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT There were found 36 cases of gallbladder cancer, an average of 3.6 new cases per year, 75% were women. The mean age was 59.5 years (40-80 r). As a major risk factor for gallstone disease found in 87%, 8% obesity, gallbladder polyp 2% without risk factor none 3% of patients presented family medical history associated with this pathology. The 100% patients were initially operated in other surgical services in the country and then were referred to our institution for better treatment in these services simple cholecystectomy was performed in 26 cases partial. Cholecystectomy in 2 cases, cholecystectomy + external drainage in 3 cases, cholecystectomy + lymph node biopsy in 3 cases, only biopsy in 2 cases for disseminated disease. 14% of patients had jaundice, choluria + acholia. The stratification at admission was a stage IV b by 83% to 11% IV and III b 6%. A pathology results it was found that the predominant Adenocarcinoma in 82% to 12% and scamous 6% poorly differentiated carcinoma. The proposed by the multidisciplinary team and in our institution treatment was surgery in 7 cases, exclusive chemotherapy in 1 case, palliative chemotherapy in 5 patients, palliative care exclusive in 18 cases. It is worth mentioning that 5 patients refused any treatment requesting voluntary discharge. Notably, one patient in the series which received surgical treatment (radical hepatic resection + lymphadenectomy IV and V) plus radiotherapy and adjuvant chemotherapy had a survival of 4 years.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[mujer]]></kwd>
<kwd lng="es"><![CDATA[vesícula biliar]]></kwd>
<kwd lng="es"><![CDATA[cáncer de la vesícula biliar]]></kwd>
<kwd lng="es"><![CDATA[colecistectomía.]]></kwd>
<kwd lng="en"><![CDATA[women]]></kwd>
<kwd lng="en"><![CDATA[gallbladder]]></kwd>
<kwd lng="en"><![CDATA[gallbladder carcinoma]]></kwd>
<kwd lng="en"><![CDATA[cholecystectomy.]]></kwd>
</kwd-group>
</article-meta>
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