BRAZILIAN CONSENSUS ON INCIDENTAL GALLBLADDER CARCINOMA.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Grupo Internacional de Estudos de Câncer Hepatopancreatobiliar - ISG-HPB-Cancer, Coimbra Felipe Jose F, Torres Orlando Jorge M, Alikhanov Ruslan, Agarwal Anil, Pessaux Patrick, Fernandes Eduardo de Souza M, Quireze-Junior Claudemiro, Araujo Raphael Leonardo C, Godoy André Luis, Waechter Fabio Luis, Resende Alexandre Prado de, Boff Marcio Fernando, Coelho Gustavo Rego, Rezende Marcelo Bruno de, Linhares Marcelo Moura, Belotto Marcos, Moraes-Junior Jose Maria A, Amaral Paulo Cezar G, Pinto Rinaldo Danesi, Genzini Tercio, Lima Agnaldo Soares, Ribeiro Heber Salvador C, Ramos Eduardo José, Anghinoni Marciano, Pereira Lucio Lucas, Enne Marcelo, Sampaio Adriano, Montagnini André Luis, Diniz Alessandro, Jesus Victor Hugo Fonseca de, Sirohi Bhawna, Shrikhande Shailesh V, Peixoto Renata D Alpino, Kalil Antonio Nocchi, Jarufe Nicolas, Smith Martin, Herman Paulo
Аннотация
AIM: To develop the first evidence-based consensus for management of patients with incidental gallbladder cancer in Brazil.
METHODS: Sixteen questions were selected, and 36 Brazilian and International members were included to the answer them. The statements were based on current evident literature. The final report was sent to the members of the panel for agreement assessment.
RESULTS: Intraoperative evaluation of the specimen, use of retrieval bags and routine histopathology is recommended. Complete preoperative evaluation is necessary and the reoperation should be performed once final staging is available. Evaluation of the cystic duct margin and routine 16b1 lymph node biopsy is recommended. Chemotherapy should be considered and chemoradiation therapy if microscopically positive surgical margins. Port site should be resected exceptionally. Staging laparoscopy before reoperation is recommended, but minimally invasive radical approach only in specialized minimally invasive hepatopancreatobiliary centers. The extent of liver resection is acceptable if R0 resection is achieved. Standard lymph node dissection is required for T2 tumors and above, but common bile duct resection is not recommended routinely.
CONCLUSIONS: It was possible to prepare safe recommendations as guidance for incidental gallbladder carcinoma, addressing the most frequent topics of everyday work of digestive and general surgeons.