Resumo
The cancer of the gallbladder unless rare, has been found in about 1% of all cholecistectomies for chronic cholecistitis. The preoperative diagnosis is difficult to be done because there are not particular symptoms. In the present paper the authors relate a case of a patient submitted to a laparoscopic cholecistectomy for acute cholecistitis. The pathologist reported a concomitant tubular adenoma in the specimen. At the 6th postoperative month the patient had intense abdominal pain, and at the 7th month, metastasis of an adenocarcinoma was detected in the port sites. The first specimen was reviewed and showed a primay adenocarcinoma of the gallbladder. The patient was submitted to chemotherapy but with few response, dying in the 9th postoperative month. The authors conclude that unless difficult, the preoperative diagnosis of cancer of the gallbladder is essential for a more appropriate therapy, mainly in the patients aging more than 50 year when the neoplasm appears with greater prevalence. Despite the videolaparoscopic access for the surgery provides low morbidity and mortality, it is not indicated for the gallbladder cancer when the conventional access by laparotomy is obligatory.
Cholecistectomy; Laparoscopy; Videolaparsocopy; Gallbladder; Cancer
Cholecistectomy; Laparoscopy; Videolaparsocopy; Gallbladder; Cancer
RELATOS DE CASOS
Metástases de adenocarcinoma de vesícula biliar em colecistectomia videolaparoscópica
Metastasis of adenocarcinoma of the gallbladder after laparoscopic cholecistectomy
Antônio Ziliotto Júnior, TCBC-SPI; José Antonio Mansur MendesI; Johann Eugen Künzle, TCBC -SPII; Fernando César Ferreira PintoI; Rogério Barbieri SichieriIII
ICirurgião do Serviço de Cirurgia de Ribeirão Preto
IIDoutor em Medicina pela UNICAMP, Chefe do Serviço de Cirurgia de Ribeirão Preto
IIIResidente do Serviço de Cirurgia de Ribeirão Preto
Endereço para correspondência Endereço para correspondência: Dr. Antonio Ziliotto Júnior Hospital São Francisco de RP - Serviço de Cirurgia Rua Garibaldi, 1271 14010-170 - Ribeirão Preto - SP
ABSTRACT
The cancer of the gallbladder unless rare, has been found in about 1% of all cholecistectomies for chronic cholecistitis. The preoperative diagnosis is difficult to be done because there are not particular symptoms. In the present paper the authors relate a case of a patient submitted to a laparoscopic cholecistectomy for acute cholecistitis. The pathologist reported a concomitant tubular adenoma in the specimen. At the 6th postoperative month the patient had intense abdominal pain, and at the 7th month, metastasis of an adenocarcinoma was detected in the port sites. The first specimen was reviewed and showed a primay adenocarcinoma of the gallbladder. The patient was submitted to chemotherapy but with few response, dying in the 9th postoperative month. The authors conclude that unless difficult, the preoperative diagnosis of cancer of the gallbladder is essential for a more appropriate therapy, mainly in the patients aging more than 50 year when the neoplasm appears with greater prevalence. Despite the videolaparoscopic access for the surgery provides low morbidity and mortality, it is not indicated for the gallbladder cancer when the conventional access by laparotomy is obligatory.
Key words: Cholecistectomy; Laparoscopy; Videolaparsocopy; Gallbladder; Cancer.
Texto completo disponível apenas em PDF.
Full text available only in PDF format.
Recebido em 14/11/97
Aceito para publicação em 2/7/98.
Trabalho realizado no Serviço de Cirurgia de Ribeirão Preto e Hospital São Francisco de Ribeirão Preto.
- 1. Schwartz SI. A vesícu1a biliar e o sistema biliar extra-hepático. In Schwartz SI, Lillehei RC, Shires GT, et al- Princípios de cirurgia. Rio de Janeiro, Guanabara Koogan, 1976, pp 1.250-1.284.
- 2. Martinez J, Targarona EM, Balagué C, et al. Port site metastasis. An unresolved problem in laparoscopic surgery. Int Surg 1995; 80: 315-321.
- 3. Dobronte Z, Wittmann T, Karacsony G. Rapid development of malignant metastases in the abdominal wall after laparoscopy. Endoscopy 1978; 10: 127-130.
- 4. Brooks DC. Reply to: laparoscopic cholecystectomy and gallbladder cancer. Surgery 1995; 117: 479-480.
- 5. Fligestone L, Rhodes M, Flook D, et al. Tumor inoculation during laparoscopy. Lancet 1993; 324:368-369.
Endereço para correspondência:
Datas de Publicação
-
Publicação nesta coleção
17 Maio 2010 -
Data do Fascículo
Out 1998
Histórico
-
Recebido
14 Nov 1997 -
Aceito
02 Jul 1998
