Tratamento do câncer primário da vesícula biliar: estudo de 40 casos
DOI:
https://doi.org/10.32635/2176-9745.RBC.1994v40n1.2969Palabras clave:
Câncer da Vesícula Biliar, Tratamento Cirúrgico, Quimioterapia, Complicações Pós-Operatórias, Mortalidade Pós-OperatóriaResumen
O tratamento cirúrgico do câncer primário da vesícula biliar geralmente é eficaz, e consiste de colecistectomia simples, colecistectomia com ressecçào em cunha do leito hepático e procedimentos cirúrgicos radicais. Isoladamente é o método terapêutico que alcança os melhores resultados. Foram estudados 40 pacientes portadores de câncer primário da vesícula biliar, diagnosticados e tratados no Departamento de Cirurgia (Serviço de Cirurgia Geraldo Hospital Universitário Clementino Fraga Filho) da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, no período de março de 1978 a dezembro de 1989. Os procedimentos cirúrgicos utilizados foram múltiplos e variados, em função do estágio evolutivo da doença, os quais foram efetuados em 36 casos (90%), sendo que em dois associou-se o tratamento quimioterápico. Das cirurgias paliativas, a colecistectomia e/ou biópsia e/ou drenagem da via biliar externa ou interna e/ou derivação do trato gastrintestinal foi procedida em 18 casos (47,4%). A laparotomia exploradora com biópsia foi feita em nove casos (23,7%,) e associada a procedimentos de drenagem biliar e/ou derivação do trânsito gastrintestinal em quatro casos (10,4%). A quimioterapia antineoplásica instituída não contribuiu para o aumento da sobrevida dos pacientes. As complicações pós-operatórias imediatas ocorreram em 16 casos (44,4%) e as tardias em 12 casos (33,3%). A mortalidade pós-operatória ocorreu em 12 casos (33,3%). Os AA compararam os seus resultados com os relatados na literatura médica.
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