Buscar en
Cirugía Española
Toda la web
Inicio Cirugía Española Actualización del diagnóstico y el tratamiento del cáncer de vesícula biliar
Información de la revista
Vol. 71. Núm. 2.
Páginas 102-111 (Febrero 2002)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 71. Núm. 2.
Páginas 102-111 (Febrero 2002)
Acceso a texto completo
Actualización del diagnóstico y el tratamiento del cáncer de vesícula biliar
Update of the diagnosis and treatment of gallbladder cancer
Visitas
22282
C.P. Ramírez1
Autor para correspondencia
cprptot@hotmail.com

Correspondencia: Dr. César P. Ramírez Plaza. Servicio de Cirugía General y Aparato Digestivo. Hospital Regional Universitario de Málaga Carlos Haya. Avda. de Carlos Haya, s/n. 29010 Málaga.
, M.A. Suárez, J. Santoyo, J.L. Fernández, M. Jiménez, J.A. Pérez, J.A. Bondía, A. de la Fuente
Unidad de Cirugía Hepatobiliopancreática y Trasplante Hepático. Servicio de Cirugía General y Aparato Digestivo (Dr. De la Fuente Perucho). Hospital Regional de Málaga Carlos Haya. Málaga
Este artículo ha recibido
Información del artículo
Resumen

El cáncer de vesícula biliar es la neoplasia maligna más frecuente del tracto biliar. Pese a los recientes avances en las técnicas de diagnóstico por imagen se detecta usualmente en estadios avanzados debido a la falta de síntomas y signos específicos de presentación, por lo que se ha asociado clásicamente a un pésimo pronóstico. La supervivencia global a 5 años en las series más numerosas está por debajo del 5%, y la mediana de supervivencia es de menos de 6 meses. No obstante, el papel de la cirugía radical se está definiendo de forma más clara recientemente. Es esencial para el cirujano comprender la historia natural, biología, estadificación y el tratamiento quirúrgico actual de estos tumores, de forma que puedan tomarse las decisiones adecuadas en el momento del diagnóstico inicial, en especial por la alta posibilidad que existe de que estas lesiones puedan encontrarse de forma incidental en el momento de una colecistectomía o en el análisis histológico posterior

Palabras clave:
Cáncer de vesícula biliar
Colecistectomía radical extendida

Carcinoma of the gallbladder is the most common biliary tract carcinoma. Even with the recent advances in hepatobiliary imaging techniques, gallbladder carcinoma is usually detected at an advanced stage because of the lack of specific symptoms and signs, leading to a very poor prognostic. The five-year survival in most large series is lesser than 5%, and median survival is lesser than 6 months. Nevertheless, the role of radical surgery is becoming more clearly defined. It is critical for the surgeon to understand the natural history, biology, staging and current surgical treatment of this tumour, so that appropriate decisions are made at the time of the initial diagnosis, especially given the high chance of these lesions being found incidentally at the time of cholecystectomy or just in the postoperative histopathologic exam

Key words:
Gallbladder carcinoma
Radical extended cholecystectomy
El Texto completo está disponible en PDF
Bibliografía
[1.]
M. De Stoll.
Berardi, (1777),
[2.]
G.T. Pack, T.R. Miller, R.D. Brasfiled.
Total right hepatic lobectomy for cancer of the gallbladder.
Ann Surg, 142 (1955), pp. 6-16
[3.]
A.A. Blalock.
A statistical study of 888 cases of biliary tract disease.
Johns Hopkins Hosp Bull, 35 (1924), pp. 391-409
[4.]
F. Potente, U. Ghiron, M. Caramia, E. Seglie, F. Fava, F. Rolfo.
Il carcinoma della colecisti. La nostra esperienza.
Minerva Chir, 49 (1994), pp. 787-790
[5.]
B. Chevrel, J.P. Chevrel.
Cancer de la vesicula biliaire.
Press Med, 79 (1971), pp. 372-377
[6.]
H.J. Wanebo, M.P. Verezidis.
Carcinoma of the gallbladder.
J Surg Oncol, 3 (1993), pp. 134-139
[7.]
C.H. Debray, J.P. Haordouin.
Les canceres primitifs de la vesicule biliaire. Donnés cliniques et evolutives à propos de 52 observations.
Arch Franc Appar Dig, 54 (1965), pp. 5
[8.]
M. Danzis.
Carcinoma of the gallbladder: a report of 52 cases.
J Mount Sinai Hosp, 17 (1951), pp. 467-477
[9.]
A.K. Diehl.
Epidemiology of gallbladder cancer: a synthesis of recent data.
JNCI, 65 (1990), pp. 1209-1213
[10.]
I. Roa, J.C. Araya, T. Shirasi.
DNA content in gallbladder carcinoma: a flow cytometric study of 96 cases.
Histopathology, 23 (1993), pp. 459-464
[11.]
J.L. Marijuán Martín, C. Rivera Vallejo, A. Mata Juberías, P. James Bazire, J. Díaz Domínguez, A. Celdrán Uriarte.
Carcinoma primario de vesícula biliar. Revisión de 41 casos.
Rev Esp Enf Digest, 82 (1992), pp. 169-171
[12.]
P.H. Gers.
Primary carcinoma of the gallbladder: a thirty years summary.
Ann Surg, 153 (1961), pp. 369-372
[13.]
J.L. Rodríguez, D. Casanova.
Carcinoma de vías biliares. Revisión de 50 casos.
Rev Esp Enf Ap Digest, 54 (1978), pp. 315-334
[14.]
J.M. Del Val Gil, A. Bermejo Zapatero, M. González Penabad, E. Auré Casanova, E. Hidalgo Lerma.
Cáncer de vesícula biliar. A propósito de 10 casos.
Cir Esp, 48 (1990), pp. 82-86
[15.]
W. Zatonski, C. La Vecchia, F. Levi.
Descriptive epidemiology of gallbladder in Europe.
J Cancer Res Clin Oncol, 119 (1993), pp. 165-171
[16.]
A.K. Diehl.
Gallstone size and the risk of gallbladder cancer.
JAMA, 250 (1983), pp. 2323-2326
[17.]
J. Hart, B. Modan, M. Shani.
Cholelithiasis in the aetiology of the gallbladder neoplasms.
Lancet, 1 (1971), pp. 1151-1153
[18.]
J.F. Fraumeni, S.S. Devesa, J.K. McLaughlin, J.L. Stanford.
Biliary tract cancer.
Cancer epidemiology and prevention. 2nd ed,
[19.]
G.A. Kune, A. Sali.
Marrapase Editore-D.E.M.I., (1981),
[20.]
J. Albores-Saavedra, M. Nadji, D.E. Henson.
Intestinal type adenocarcinoma of the gallbladder. A clinico-pathologic study of seven cases.
Am J Surg Pathol, 10 (1986), pp. 19-25
[21.]
J.C. Welton, J.S. Marr, S.M. Friedman.
Association between cancer and typhoid carrier state.
Lancet, 1 (1979), pp. 791-794
[22.]
D.M. England, J.E. Rosenblatt.
Anaerobes in human biliary tracts.
J Clin Microbiol, 6 (1977), pp. 494
[23.]
W. Kimura, T. Muto, Y. Esaki.
Incidence and pathogenesis of villous tumors of the gallbladder, and their relation to cancer.
J Gastroenterol, 29 (1994), pp. 1-4
[24.]
S. Kozuka, N. Tsubone, A. Yasui, K. Hachisuka.
Relation of adenoma to carcinoma of the gallbladder.
Cancer, 50 (1982), pp. 2226-2234
[25.]
K. Kimura, M. Ohto, H. Saisho.
Association of gallbladder carcinoma and anomalous pancreato-biliary union.
Gastroenterology, 89 (1995), pp. 1258-1265
[26.]
M.T. Carriaga, D.E. Henson.
Liver, gallbladder, extrahepatic bile ducts and cancer.
Cancer, 75 (1995), pp. 171-190
[27.]
M. Yamamoto, S. Nakajo, E. Tahara.
Carcinoma of the gallbladder: the correlation between histogenesis and prognosis.
Virchow Arch Pathol Anat Histopathol, 414 (1989), pp. 83-90
[28.]
K. Sumiyoshi, E. Nagai, K. Chijiiwa.
Pathology of the carcinoma of the gallbladder.
World J Surg, 15 (1991), pp. 315-321
[29.]
A.J. Reese.
Primary carcinoma simulating empyema of the gallbladder.
BMJ, 2 (1953), pp. 430
[30.]
J. Albores-Saavedra, D.E. Henson.
Armed Forces Institute of Pathology, (1986),
[31.]
R.B. Fahim, J.R. McDonald, J.C. Richards, O.F. Dewrad.
Carcinoma of the gallbladder: a study of its modes of spread.
Ann Surg, 156 (1962), pp. 114-124
[32.]
M. Ohtsuka, M. Miyazaki, H. Itoh, K. Nakagawa, S. Ambiru, H. Shimizu, et al.
Routes of hepatic metastases of gallbladder carcinoma.
Am J Clin Pathol, 109 (1998), pp. 62-68
[33.]
Y. Shirai, K. Tsukada, T. Ohtani, H. Watanabe, K. Hatakeyama.
Hepatic metastases from carcinoma of the gallbladder.
Cancer, 75 (1995), pp. 2063-2068
[34.]
E.J. Boerma.
Towards an oncological resection of gallbladder cancer (review of 61 refs.).
Europ J Surg Oncol, 20 (1994), pp. 537-544
[35.]
Y. Shirai, K. Yoshida, K. Tsukada, T. Ohtani, T. Muto.
Identification of the regional lymphatic system of the gallbladder by vital staining.
Br J Surg, 79 (1992), pp. 659-662
[36.]
K. Tsukada, I. Kurosaki, K. Uchida, Y. Shirai, Y. Oohashi, K. Yokoyama, et al.
Lymph node spread from carcinoma of the gallbladder.
Cancer, 80 (1997), pp. 661-667
[37.]
J.E. Nevin, T.J. Moran, S. Kay, R. King.
Carcinoma of the gallbladder: staging, treatment and prognosis.
Cancer, 37 (1976), pp. 141-148
[38.]
J.H. Donohue, D.M. Nagomey, C.S. Grant, K. Tsushima, D.M. Istrup, M.A. Adson.
Carcinoma of the gallbladder. Does radical resection improve outcome?.
Arch Surg, 125 (1990), pp. 237-241
[39.]
I.D. Fleming, J.S. Cooper, D.E. Henson.
JB Lippincott & Company, (1997),
[40.]
H. Onoyama, M. Yamamoto, A. Tseng, T. Ajiki, Y. Saitoh.
Extended cholecystectomy for carcinoma of the gallbladder.
World J Surg, 19 (1995), pp. 758-763
[41.]
D.L. Barlett, Y. Fong, J.G. Fortner, M.F. Brennan, L.H. Blumgart.
Long terms results after resection for gallbladder cancer. Implications for staging and management.
Ann Surg, 224 (1996), pp. 639-646
[42.]
J.H. North, M.S. Pack, C. Hong, D.E. Rivera.
Prognostic factors for adenocarcinoma of the gallbladder: an analysis of 162 cases.
Ann Surg, 64 (1998), pp. 437-440
[43.]
T.C. Chao, J.A. Greager.
Primary carcinoma of the gallbladder.
J Clin Oncol, 46 (1991), pp. 215-221
[44.]
I.A. Gradisor, T.R. Kelly.
Primary carcinoma of the gallbladder.
Arch Surg, 100 (1970), pp. 232-239
[45.]
M. Miyazaki, H. Itoh, S. Ambiru, H. Shimizu, A. Togawa, E. Gohchi, et al.
Radical surgery for advanced gallbladder carcinoma.
Br J Surg, 83 (1996), pp. 478-481
[46.]
B.L. Strom, G. Maislin, S.L. West, B. Atkinson, M. Herlyn, S. Saul, H.A. Rodríguez Martínez, et al.
Serum CEA and CA19-9: potential future diagnostic or screening tests for gallbladder cancer?.
Intl J Cancer, 45 (1990), pp. 821-824
[47.]
R.E. Ritts, D.M. Nagorney, D.J. Jacobson, R.W. Talbot, V.R. Zurawski Jr.
Comparison of preoperative serum CA19-9 levels with results of diagnostic imaging modalities in patients undergoing laparotomy for suspected pancreatic or gallbladder disease?.
Pancreas, 9 (1999), pp. 707-716
[48.]
L.A. Wibbenmeyer, T.P. Wade, R.C. Chen, R.C. Meyer, R.P. Turgeon, C.H. Andrus.
Laparosopic cholecystectomy can disseminate in situ carcinoma of the gallbladder.
J Am Coll Surg, 181 (1995), pp. 504-510
[49.]
A. Kumar, S. Ahggarwal.
Carcinoma of the gallbladder: CT findings in 50 cases.
Abdom Imag, 19 (1994), pp. 304-308
[50.]
T. Ohtani, Y. Shirai, K. Tsukada, K. Hatakeyama, T. Muto.
Carcinoma of the gallbladder: CT evaluation of lymphatic spread.
Radiology, 189 (1993), pp. 875-880
[51.]
K. Chijiiwa, K. Sumiyoshi, F. Nakayama.
Impact of recent advances in hepatobiliary imaging techniques on the preoperative diagnosis of carcinoma of the gallbladder.
World J Surg, 15 (1991), pp. 322-327
[52.]
A.C. Wilbur, B. Gyi, S.A. Renigres.
High-field MRI of primary gallbladder carcinoma.
Gastrointest Radiol, 170 (1988), pp. 1491-1495
[53.]
K. Yasuda, H. Mukai, S. Fujimoto, M. Nakajima, K. Kawai.
The diagnosis of pancreatic cancer by endoscopic ultrasonography.
Gastrointest Endoscopy, 34 (1988), pp. 1-8
[54.]
F. Gress, S. Ikemberry, S. Sherman, J. Wonn, G. Lehman.
A prospective comparison of endoscopic ultrasound (EUS) versus spiral computed tomography (SCT) for pancreatic, biliary and ampullary cancer staging and determination of vascular invasion and resectability.
Gastrointest Endoscopy, 43 (1996), pp. 422-425
[55.]
Y. Fong, M.F. Brennan, A. Turnbull, D.G. Coit, L.H. Blumgart.
Gallbladder cancer discovered during laparoscopic surgery: potential for iatrogenic dissemination.
Arch Surg, 128 (1993), pp. 1054-1056
[56.]
A.B. Akosa, F. Barker, L. Desa, I. Benjamin, T. Krausz.
Cytologic diagnosis in the management of gallbladder carcinoma.
Acta Cytol, 39 (1995), pp. 494-498
[57.]
P.A. Grace, A. Quereshi, J. Coleman, R. Keane, G. McEntee, P. Broe, et al.
Reduced postoperative hospitalization after laparosocpic cholecystectomy.
Br J Surg, 78 (1991), pp. 160-162
[58.]
A.E. Ricardo, B.W. Feig, L.M. Ellis, K.K. Hunt, S.A. Curley, B.V. MacFadyen, et al.
Gallbladder cancer and trocar recurrence sites.
Am J Surg, 174 (1997), pp. 619-623
[59.]
L. Sarli, S. Contini, G. Sansebastiano, S. Gobbi, R. Costi, L. Roncoroni.
Does laparoscopic cholecystectomy worsen the prognosis of unsuspected gallbladder cancer?.
Arch Surg, 135 (2000), pp. 1340-1344
[60.]
T. Tsunoda, R. Tsuchiya, N. Harada.
The surgical treatment for carcinoma of the gallbladder: rational for second look operation for inapparent carcinoma.
Jpn J Surg, 17 (1987), pp. 478-486
[61.]
G. Winde, G. Kautz, T. Berns.
Therapeutic problems of cancer of the gallbladder.
J Chir, 130 (1993), pp. 252-259
[62.]
S. Benoist, Y. Panis, P.L. Fagniez.
Long-term results after curative resection for carcinoma of the gallbladder.
Am J Surg, 175 (1998), pp. 118-122
[63.]
K. Ouchi, Y. Owada, S. Matsuno, T. Sato.
Prognostic factors in the surgical treatment of gallbladder carcinoma.
Surgery, 101 (1987), pp. 731-737
[64.]
Y. Shirai, K. Yoshida, K. Tsukada, T. Muto.
Inapparent carcinoma of the gallbladder. An appraisal of radical second operation after simple cholecystectomy.
Ann Surg, 215 (1992), pp. 326-331
[65.]
X. De Aretxabala, I.S. Roa, L.A. Burgos, J.C. Araya, M.A. Villaseca, J.A. Silva.
Curative resection in potentially resectable tumours of the gallbladder.
Europ J Surg, 163 (1997), pp. 419-426
[66.]
K. Yamaguchi, K. Chijiiwa, S. Saiki, K. Nishihara, M. Takashima, K. Kawakami, et al.
Retrospective analysis of 70 operations for gallbladder carcinoma.
Br J Surg, 84 (1997), pp. 200-204
[67.]
Y. Fong, W. Jarnagin, L.H. Blumgart.
Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior non-curative resection.
Ann Surg, 232 (2000), pp. 557-569
[68.]
F.P. Gall, F. Köckerling, J. Scheele, C. Schneider, W. Hohenberger.
Radical operations for carcinoma of the gallbladder: present status in Germany.
World J Surg, 15 (1991), pp. 328-336
[69.]
K. Konishi, H. Sahara, N. Kadoya.
Clinical study on gallbladder cancer invading into subserosal layer with special reference to the relationship between extent of cancer and prognosis.
J Jpn Biliary Assoc, 7 (1993), pp. 13-20
[70.]
T. Izumi, H. Shimada, M. Maehara.
Modes of spread and surgical strategy for gallbladder carcinoma with subserosal invasion.
J Jpn Surg Soc, 94 (1993), pp. 722
[71.]
F. Glenn, D.M. Hays.
The scope of radical surgery in the treatment of malignant tumors of the extrahepatic bile duct.
Surg Gynecol Obst, 99 (1954), pp. 529-541
[72.]
H. Shimada, T. Endo, S. Togo, A. Nakano, T. Izumi, G. Nakagawara.
The role of lymph node dissection in the treatment of gallbladder carcinoma.
Cancer, 79 (1997), pp. 892-899
[73.]
K. Chijiiwa, K. Yamaguchi, M. Tanaka.
Clinicopathologic differences between long-term and short-term postoperative survivors with advanced gallbladder carcinoma.
World J Surg, 21 (1997), pp. 98-102
[74.]
K. Tsukada, K. Hatakeyama, I. Kurosaki, K. Uchida, Y. Shirai, T. Muto, et al.
Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage.
Surgery, 120 (1996), pp. 816-821
[75.]
K. Chiijiwa, H. Noshiro, K. Nakano, M. Okido, A. Sugitani, K. Yamaguchi, et al.
Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using Western and Japanese Classification Systems.
World J Surg, 24 (2000), pp. 1271-1277
[76.]
S. Kondo, Y. Nimura, N. Hayakawa, J. Kamiya, M. Nagino, K. Uesaka.
Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma.
[77.]
D.L. Barlett, Y. Fong.
Tumors of the gallbladder.
Surgery of the liver and biliary tract (vol. I). 1st. ed. 1994, pp. 993-1051
[78.]
M. Gagner, R.L. Rossi.
Radical operations for carcinoma of the gallbladder: present status in Germany.
World J Surg, 15 (1991), pp. 344-347
[79.]
Y. Ogura, R. Mizumoto, S. Isaji, T. Kusuda, S. Matsuda, M. Tabata.
Radical operations for carcinoma of the gallbladder: present status in Japan.
World J Surg, 15 (1991), pp. 337-343
[80.]
Y. Shirai, K. Yoshida, K. Tsukada, T. Muto, H. Watanabe.
Radical surgery for gallbladder carcinoma. Long-term results.
Ann Surg, 216 (1992), pp. 565-568
[81.]
Y. Matsumoto, H. Fujii, H. Aoyama, M. Yamamoto, K. Sugahara, K. Suda.
Surgical treatment of primary gallbladder carcinoma based on the histologic analysis of 48 surgical specimens.
Am J Surg, 163 (1992), pp. 239-245
[82.]
P. Cubertafond, A. Gainant, G. Cucchiaro.
Surgical treatment of 724 carcinomas of the gallbladder. Results of the French Surgical Association Survey.
Ann Surg, 219 (1994), pp. 275-280
[83.]
B.G. Taal, R.A. Audisio, H. Bleiberg, G.H. Blijham, J.P. Neijt, C.H. Veenhof, et al.
Phase II trial of mitomycin C (MMC) in advanced gallbladder and biliary tree carcinoma. An EORTC gastrointestinal tract cancer cooperative group study.
Ann Oncol, 1 (1993), pp. 607-609
[84.]
C.E. Oswalt, A.B. Cruz Jr.
Effectiveness of chemotherapy in addition to surgery in treating carcinoma of the gallbladder.
Rev Surg, 34 (1977), pp. 436-438
[85.]
J.T. Makela, M.I. Kairaluoma.
Superselective intra-arterial chemotherapy with mitomycin C for gallbladder cancer.
Br J Surg, 80 (1993), pp. 912-915
[86.]
S. Houry, M. Sclienger, M. Hugnier, F. Lacaine, F. Penne, A. Laugier.
Gallbladder carcinoma: role of radiation therapy.
Br J Surg, 76 (1989), pp. 448-450
[87.]
P.M. Busse, B. Cady, A. Bothe Jr, R. Jenkins, W.V. McDermott, G. Steele Jr, et al.
Intraoperative radiation therapy for carcinoma of the gallbladder.
World J Surg, 15 (1991), pp. 352-356
[88.]
T. Todoroki, Y. Iwasaki, K. Orii, M. Otsuka, K. Ohara, T. Kawamoto, et al.
Resection combined with intraoperative radiation therapy (IORT) for stage IV gallbladder carcinoma.
World J Surg, 15 (1991), pp. 357-366
[89.]
D. Oertli, U. Herzog, P. Todelli.
Primary carcinoma of the gallbladder: operative experience during a 16 year period.
Europ J Surg, 159 (1993), pp. 415-420
[90.]
H.J. Wanebo, W.N. Castle, R.E. Fechner.
Is carcinoma of the gallbladder a curable lesion?.
Ann Surg, 196 (1982), pp. 624-631
[91.]
R. Soupault, C. Couinaud.
Sur un procédé nouveau de dérivation biliaire intrahépatique: les cholángio-jéjunostomies gauches sans sacrifice hépatique.
Presse Med, 65 (1957), pp. 1157-1159
[92.]
V.K. Kapoor, R. Pradeep, S.P. Haribhakti, V. Singh, S.S. Sikora, R. Saxena, et al.
Intrahepatic segment III cholangiojejunostomy in advanced carcinoma of the gallbladder.
Br J Surg, 83 (1996), pp. 1709-1711
[93.]
R. Saxena, S.S. Sikora, S.P. Kaushik.
A triple bypass procedure for advanced carcinoma of the neck of gallbladder.
Br J Sur, 82 (1995), pp. 394-395
[94.]
W.P. Longmire, M.C. Sanford.
Intrahepatic cholangiojejunostomy with partial hepatectomy for biliary obstruction.
Surgery, 128 (1948), pp. 330-337
Copyright © 2002. Asociación Española de Cirujanos
Opciones de artículo
Herramientas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos