Palabras clave
Adenocarcinoma
Epidemiología
Factores de riesgo
Diagnóstico
Terapéutica Gallbladder neoplasms
Adenocarcinoma
Epidemiology
Risk factors
Diagnosis
Therapeutics
Cómo citar
Resumen
El adenocarcinoma de vesícula biliar es una patología poco frecuente, se presenta entre 0,5 y 3% de todas las colecistectomías, y es la principal neoplasia maligna de la vía biliar. Es mayor su presentación en mujeres, durante la sexta década de la vida, en pacientes con colelitiasis y en raza indígena. El diagnóstico prequirúrgico es raro, ya que la clínica es inespecífica, y la capacidad discriminatoria en los estudios imagenológicos de patologías de la vía billar es pobre, en especial en estadios tempranos. En las últimas dos décadas la mortalidad ha disminuido debido a un abordaje quirúrgico temprano así como el advenimiento de terapias neoadyuvantes, sin embargo es una neoplasia muy agresiva y la mortalidad es alta en estadios avanzados. En los pacientes con carcinoma in situ y estadios T1a el manejo con colecistectomía simple es el abordaje indicado, con una sobrevida a 5 años mayor al 95%. En los pacientes estadios T1b o mayores, existen controversias en cuanto al tipo de abordaje y en los beneficios de la terapia adyuvante con radio o quimioterapia, aunque se ha visto una mejor respuesta en los pacientes con compromiso ganglionar. Este artículo revisa los conocimientos actuales acerca de la epidemiología, etiopatogenia, factores de riesgo y tratamiento de los pacientes con adenocarcinoma de vesícula.
Citas
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