An approach to histologically diagnosed gallbladder carcinoma following cholecystectomy for presumed benign disease
| Autor: | Bernardo Aizen, Celso Silva, Luis Bergalli, Carlos Misa, Edgardo Torterolo, Ricardo Beltran |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Adenocarcinoma Gastroenterology Diagnosis Differential Cholelithiasis Internal medicine medicine Carcinoma Humans Cholecystectomy Neoplasm Invasiveness Aged Neoplasm Staging Porta hepatis business.industry Gallbladder General Medicine Middle Aged Prognosis medicine.disease Surgery Survival Rate medicine.anatomical_structure Oncology Lymph Node Excision Female Gallbladder Neoplasms Liver function Gallbladder Neoplasm Hepatectomy business Follow-Up Studies |
| Zdroj: | Journal of Surgical Oncology. 53:175-178 |
| ISSN: | 1096-9098 0022-4790 |
| Popis: | Five cases of gallbladder adenocarcinoma treated at Surgical Department 2, Maciel Hospital, Montevideo, Uruguay, in a period ranging from 1985 to 1989 and follow-up to date are reported. All cases were first diagnosed by microscopic examination of the gallbladder, which had been removed for presumed benign disease; there were no intramucosal carcinomas, and 60% of the cases were classified as Nevin's stage II (submucosal and muscularis). Based on the pattern of spread (mainly direct hepatic infiltration, as well as venous and lymphatic involvement), our radical surgical treatment of gallbladder carcinoma includes cholecystectomy, extended lymphatic clearance (along the porta hepatis or R1, pre- and retroduodenopancreatic and hepatic artery R2, and celiac axis R3), and medial hepatectomy (segments, IV, V, and VIII according to Couinaud). Simple cholecystectomy is the treatment of choice in mucosal (T1) neoplasms; otherwise, histologically diagnosed gallbladder carcinoma following cholecystectomy for presumed benign disease calls for reoperation to achieve lymph node dissection and hepatic resection. Overall 2- and 3-year survival was 100% and 80%; mean survival was 50 months. Medial hepatectomy was selected according to gallbladder carcinoma patterns of spread and failures, and entails resection of the parenchyma most frequently involved without compromising liver function, in a quick and safe surgical procedure. |
| Databáze: | OpenAIRE |
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