colecistectomia radical
TRANSCRIPT
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
cáncer temprano de cáncer temprano de vesícula como hallazgovesícula como hallazgo ¿ qué hacer luego de ¿ qué hacer luego de
colecistectomía? colecistectomía?
Dr. Enrique Ortiz QuevedoDr. Enrique Ortiz Quevedo
Cirujano oncólogoCirujano oncólogo
Sala San AurelioSala San Aurelio
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
EpidemiologíaEpidemiología
Es el cáncer mas frecuente del Es el cáncer mas frecuente del tracto biliartracto biliar
> hombres que mujeres 3-1> hombres que mujeres 3-1 Edad > 70 aEdad > 70 a
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Factores de riesgoFactores de riesgo
Litiasis vesicularLitiasis vesicular Pólipos vesicularesPólipos vesiculares Vesícula en porcelanaVesícula en porcelana Portadores de tifoideaPortadores de tifoidea Nitrosaminas Nitrosaminas
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Tipos histológicosTipos histológicos
AdenocarcinomasAdenocarcinomas– PapilarPapilar– Nodular Nodular – TubularTubular
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
TNMTNM
Tis – tumor in situ Tis – tumor in situ T1a invade hasta la lamina propia.T1a invade hasta la lamina propia. T1b invade la capa muscularT1b invade la capa muscular T2 Invade la capa perimuscularT2 Invade la capa perimuscular T3 Invade serosa u órganos T3 Invade serosa u órganos
adyacentes adyacentes T4 Invade vena porta o arteria T4 Invade vena porta o arteria
hepatica, u órganos extrahepaticos hepatica, u órganos extrahepaticos
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Hallazgo incidentalHallazgo incidental
T1b o mayorT1b o mayor– Reseccion en cuña de hígadoReseccion en cuña de hígado– Linfadenectomia regionalLinfadenectomia regional– Reseccion de vía biliar si está Reseccion de vía biliar si está
comprometidacomprometida
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Hallazgo incidentalHallazgo incidental
T1a El paciente se puede dejar en T1a El paciente se puede dejar en observación, siempre y cuando la observación, siempre y cuando la vesícula salga intactavesícula salga intacta
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Ganglios de Vena Ganglios de Vena PortaPorta
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Maniobra de KocherManiobra de Kocher
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Vena Cava inferiorVena Cava inferior
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Ganglio para aorticos y Ganglio para aorticos y para cavales para cavales
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Ganglios paracavalesGanglios paracavales
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Ganglios paraaorticos Ganglios paraaorticos
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Cuña hepáticaCuña hepática
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Cuña HepáticaCuña Hepática
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
LECHO HEPATICOLECHO HEPATICO
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Lecho HepáticoLecho Hepático
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National comprehensive cancer network- National comprehensive cancer network- Guidelines 2007 Guidelines 2007
Terapia adyuvanteTerapia adyuvante
Quimioterapia a base de 5 Quimioterapia a base de 5 Fluoracilo mas radioterapia Fluoracilo mas radioterapia