Câncer da Vesícula Biliar. Um Caso Tratado por Colecistectomia e Hepatectomia Parcial

Abstract

A case of cancer of the gall-bladder with partial invasion of the liver is reported. The patient 68 years old had severe pains in her right upper abdominal quadrant. A hard tumor was palpated there. Cholecystogram was negative and radioloqical examination of the stomach showed ao extrinsic deforrnaty of the antra. A tentative diagnosis of gall bladder câncer was made and was confirrned by laparotomy. The liver around the gall bladder was greatly invaded by the tumor and part of the stomach was very adherent to it. Cholecistectomy with partial hepatectomy and partial atypical gastrectomy were performed by the author. A hemostatic suture was placed in the liver before it was severed by the electrical knife. The abdomen was closed with no drainage. A biliary fistula developed a few days afterwards but within a month. The patient was free form pain during 8 months although after the 4th. month she would have now and then severe icterus, She died 9 months after the operation with recurence of hepatic metastases. The gallbladder showed a big solitary calculus and histological examination showed the tumor to be a "papillary carcinoma". The author does not expect gallbladder cancer so advanced as the one reported can be cured, but believes that cholecystectomy with partial hepatectomy will brinq some relief to the patient and carry him on comfortably for some time. Therefore, when possible, operation should be continued rather then justa removing a piece of tissue for biopsy and closinq the abdômen.