Câncer de vesícula biliar: experiência de 10 anos em um hospital de referência da Amazônia

Geraldo Ishak,Felipe Soares Ribeiro,Leandro Augusto Costa Bahia,Daniel Souza Da Costa,Everton Mesquita Dias,Paulo Pimentel De Assumpção

doi:10.1590/s0100-69912011000200006

Geraldo Ishak, Felipe Soares Ribeiro + Show 4 more

Open Access

https://doi.org/10.1590/s0100-69912011000200006

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Abstract

To evaluate the epidemiological aspects of surgical patients with gallbladder cancer (GC) enrolled in a University Hospital in Bethlehem (State of Pará - PA), in the period 1999-2009. observational, retrospective, descriptive and analytical study of secondary sources of patients with GC in the period 1999-2009. We analyzed 75 medical records, with 34 patients studied. The information collected was used for the TNM tumor staging of GC and to characterize the clinical and surgical population. 79% were female, mean age 66.2 ± 11 years and duration of symptoms was 10.8 ± 17.2 months, with no statistical relationship with the stage of disease. Pain in right upper quadrant, nausea and jaundice prevailed as signs / symptoms. Gallstones were present in 91% of cases and were positive in 100% of patients with stage I / II. The sensitivity of ultrasound to preoperatively suggest GC was 14.28%. The simplest operation performed was cholecystectomy, with the predominant intraoperative finding being hepatic invasion. Adenocarcinoma was the predominant histologic type, especially for stages III and IV. The present study showed high incidence of gallstone disease. Advanced stage adenocarcinoma was the most prevalent. This resulted in a low rate of operations with curative intent, in 30% of the patients, and a mortality rate of 21%. The appreciation of symptoms and early investigation by imaging could facilitate treatment in early stages of GC, providing a better prognosis for patients.

Highlights

The neoplasm of gallbladder is a relatively rare disease, despite being the most common tumor of the biliary tract and the fifth most frequent of the gastrointestinal tract. It shows a high rate of mortality, as in most cases the patient presents with nonspecific symptoms and already in advanced disease stages[1,2,3]
One may cite as the most important the presence of cholelithiasis, which would be responsible for a process of chronic inflammation with consequent formation of dysplasia-adenocarcinoma, this risk being even higher when there is presence of calculi above 3 cm
The majority of cases are diagnosed in advanced stages, resulting in unfavorable prognosis . 1,2,6-8 The population of this study showed 85% of cases in advanced stage, a fact that may be favored by symptoms that do not always express the severity of the disease, with consequent late suspicion

Summary

INTRODUCTION

The neoplasm of gallbladder is a relatively rare disease, despite being the most common tumor of the biliary tract and the fifth most frequent of the gastrointestinal tract. It shows a high rate of mortality, as in most cases the patient presents with nonspecific symptoms and already in advanced disease stages[1,2,3]. The higher incidence of malignant neoplasm of the gallbladder occurs in women over 65 years.

RESULTS

DISCUSSION

Intraoperative Findings n