Colelitíase e câncer de vesícula biliar

Abstract

OBJETIVO: O presente estudo tem por objetivo analisar os achados histológicos da vesícula biliar de pacientes submetidos à colecistectomia eletiva no Hospital Universitário Presidente Dutra, São Luís-MA. MÉTODO: Foram avaliados 2.008 pacientes, 359 do sexo masculino (17,9%) e 1.649 do sexo feminino (82,1%), com média de idade de 46,3 anos, operados no período de janeiro de 1990 a dezembro de 1998. A vesícula biliar, imediatamente após a colecitectoma era aberta e examinada macroscopicamente pelo cirurgião e em seguida enviada para exame histopatológico. RESULTADOS: A prevalência de câncer da vesícula biliar foi de 2,3 % (46 pacientes). Trinta e três pacientes (71,7%) apresentavam idade superior a 60 anos. CONCLUSÕES: Os autores concluem que a colecistectomia profilática eletiva deve ser realizada em pacientes assintomáticos com colelitíase, com idade superior a 60 anos e em boas condições cirúrgicas.

Prevalence of Incidental Gallbladder Cancer in a Tertiary-Care Hospital From Pernambuco, Brazil

“…Accordingly, we considered important to present our experience with the management of iGBC and to provide an estimation of how prevalent is the incidental diagnosis of this rare neoplasm in our State. In contrast to previous report of 2.3% from other State of our region (Maranhão, Northeast Brazil) (17) , only 0.34% of patients were found as presenting iGBC in our sample. Worldwide, such iGBC have been detected histologically in about 0.3%-3% of cholecystectomies performed for cholelithiasis (7) .…”

“…Cholecystectomy alone -mainly laparoscopic cholecystectomy -is an adequate treatment for pT1a tumors whereas additional radical surgery plus lymph node dissection might be needed to achieve a tumor-free surgical margin for pT2 and pT3 patients (2,6,8,10,13,14,17) . Herein, an aggressive reoperation for iGBC is usually warranted as the majority of patients have residual disease after the radical surgery (9,14) , as we noticed in our study.…”

“…A satisfactory outcome of patients suffering from GBC is critically dependent on an early diagnosis and most of these patients are usually faced with a poor prognosis due to diagnosis at later stages (7) . On the other hand, some of GBCs have been uncovered fortunately as an incidental gallbladder cancer (iGBC) at the time of cholecystectomy due to cholelithiasis (6,7,14,15,17) . Since discovering of GBC incidentally may offer the best opportunity for a curative approach in this aggressive neoplasm, the current study aimed to explore the prevalence of iGBC in our tertiary-care hospital from the State of Pernambuco (Brazil), supposing a highly variable prevalence through our country.…”

Prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia: experiência do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas – UNICAMP

“…Weston et al 16 showed an incidental diagnosis of the disease of 0.012% in a study carried out in a population of the State of Rio Grande do Sul. Torres et al 17 , in a study similar to ours, found a prevalence of 2.3% in patients from São Luiz, Sate of Maranhão. The difference between the values in the different population samples studied once again suggests the importance of the ethnic-genetic component of the neoplasia.…”

“…In Brazil, there are no population studies analyzing the incidence of gallbladder cancer. There are, however, some studies of regional prevalence and incidental diagnosis, with different results when compared with each other [13][14][15][16][17] . Therefore, the real incidence of gallbladder cancer in our country remains unknown.…”